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Sleep disturbances in euthymic bipolar patients

Sharon Brill, BS

Mood Disorders Research Program, Department of Psychiatry, and Behavioral Science, University of Louisville School of Medicine, Louisville, KY, USA

Praveen Penagaluri, MD

Mood Disorders Research Program, Department of Psychiatry, and Behavioral Science, University of Louisville School of Medicine, Louisville, KY, USA

R. Jeannie Roberts, MD

Mood Disorders Research Program, Department of Psychiatry, and Behavioral Science, University of Louisville School of Medicine, Louisville, KY, USA

YongLin Gao, MD

Mood Disorders Research Program, Department of Psychiatry, and Behavioral Science, University of Louisville School of Medicine, Louisville, KY, USA

Rif S. El-Mallakh, MD

Mood Disorders Research Program, Department of Psychiatry, and Behavioral Science, University of Louisville School of Medicine, Louisville, KY, USA

BACKGROUND: Sleep disturbance has been implicated in both prodromal and syndromal phases of bipolar illness.

METHODS: Charts of bipolar disorder (BD) patients who had been euthymic for at least 2 months were reviewed for mood symptoms, Clinical Global Impression scores, Global Assessment of Functioning scores, and sleep.

RESULTS: Among 116 patients, 10 never achieved a euthymic interval of 2 months’ duration. Among the remaining 106 euthymic patients, 59 (55.6%) had BD I, 23 (21.7%) had BD II, and 24 (22.8%) had BD not otherwise specified (NOS). The mean age was 43.3±SD 14.6, and 35% were male. A total of 25 patients (23.6%) had a clinically significant ongoing sleep disturbance (27.1% of those with BD I, 21.7% of those with BD II, and 16.6% of those with BD NOS). Of 16 patients for whom a sleep description was available, 25% had difficulty falling asleep, 81.25% had middle insomnia (2 patients experienced both), and none had early morning awakening. Eleven patients (10.4%) received sleep aids, and 33 (31.1%) received sedating antipsychotics (3 patients received both).

CONCLUSIONS: Sleeping aids and sedating antipsychotics can potentially disguise an underlying sleep disturbance. Thus, it is possible that study patients taking these medications (n=58; 54.7%) suffer from a sleep disturbance that is being adequately or inadequately treated.

KEYWORDS: bipolar disorder, euthymia, sleep disturbance, insomnia, sleep aids, manic induction

ANNALS OF CLINICAL PSYCHIATRY 2011;23(2):113–116

CORRESPONDENCE: Rif S. El-Mallakh, MD, Mood Disorders Research Program, Department of Psychiatry, and Behavioral Science, University of Louisville School of Medicine, MedCenter One, 501 East Broadway, Suite 340, Louisville, KY 40202 USA E-MAIL: rselma01@louisville.edu
Annals of Clinical Psychiatry ©2011 Quadrant HealthCom Inc.

 
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