Optimisation Thérapeutique en Neuropsychopharmacologie, INSERM U1144, Université de Paris, Paris, France; AP-HP Nord, GH Saint-Louis-Lariboisière-Fernand-Widal, DMU Neurosciences, Département de Psychiatrie et de Médecine Addictologique, Paris, France; Université Paris Cité, Paris, France.
Optimisation Thérapeutique en Neuropsychopharmacologie, INSERM U1144, Université de Paris, Paris, France; Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK.
J Affect Disord. 2024 Mar 1;348:224-228. doi: 10.1016/j.jad.2023.12.075. Epub 2023 Dec 29.
Disturbances in sleep and circadian rhythmicity (CR) are frequent in individuals with bipolar disorders (BD). Very few studies explored the associations between psychotropic medications and these disturbances in euthymic BD. Therefore, we aimed at exploring the associations between several classes of medications (lithium, sedative/non-sedative Atypical Antipsychotics (AAP), anticonvulsants, antidepressants, benzodiazepines) and sleep disturbances and CR dimensions in a sample of euthymic individuals with BD.
We included euthymic adults with BD type 1 or 2 assessed with 21 days of actimetry. We used a Principal Component Analysis (PCA) of sleep and CR estimates to generate dimensions to be studied in association with the current use of psychotropic medications, with adjustments for potential confounding factors.
We included individuals with BD-1 (n = 116) or BD-2 (n = 37). The PCA led to four dimensions of sleep and CR estimates. Benzodiazepines were associated with better sleep quality (p = 0.032). Aripiprazole was associated with less robust CR (p = 0.016), but with earlier peak of activity patterns (p = 0.020). Sedative AAPs were associated with better sleep quality, which was no longer significant after correction. We found no association between lithium or anticonvulsants and CR.
The cross-sectional design and the possible non-representativeness of the sample were limitations of our study.
In euthymic individuals with BD, benzodiazepines may have a positive effect on sleep quality, while aripiprazole may have mixed effects on CR (less robust but with earlier peak of activity patterns). No association with lithium or anticonvulsants observed. Further studies are warranted to replicate and extend these results.
睡眠和昼夜节律（CR）紊乱在双相情感障碍（BD）患者中很常见。很少有研究探讨心境稳定的 BD 患者中精神药物与这些紊乱之间的关系。因此，我们旨在探讨几种药物类别（锂、镇静/非镇静抗精神病药（AAP）、抗惊厥药、抗抑郁药、苯二氮䓬类）与睡眠紊乱和 CR 维度之间的关系在一组心境稳定的 BD 患者样本中。
我们纳入了经过 21 天活动记录仪评估的 1 型或 2 型双相情感障碍成人患者。我们使用睡眠和 CR 估计的主成分分析（PCA）来生成要与当前使用精神药物相关联的维度，同时调整潜在的混杂因素。
我们纳入了 116 名双相情感障碍 1 型或 37 名双相情感障碍 2 型患者。PCA 得出了睡眠和 CR 估计的四个维度。苯二氮䓬类药物与更好的睡眠质量相关（p=0.032）。阿立哌唑与更弱的 CR 相关（p=0.016），但活动模式的峰值更早（p=0.020）。镇静 AAP 与更好的睡眠质量相关，在纠正后不再显著。我们没有发现锂或抗惊厥药与 CR 之间的关联。
横断面设计和样本的可能非代表性是我们研究的局限性。
在心境稳定的 BD 患者中，苯二氮䓬类药物可能对睡眠质量有积极影响，而阿立哌唑可能对 CR 有混合影响（较弱但活动模式的峰值更早）。未观察到与锂或抗惊厥药相关。需要进一步研究来复制和扩展这些结果。
