The sleep of remitted bipolar outpatients: a controlled naturalistic study using actigraphy
The sleep of remitted bipolar outpatients: a controlled naturalistic study using actigraphy
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DOI：
10.1016/s0165-0327(03)00055-7
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发表时间：
2004-06-01
影响因子：
6.6
通讯作者：
Scott, J
中科院分区：
文献类型：
--
作者：
Millar, A;Espie, CA;Scott, J
背景：一些睡眠实验室研究表明双相情感障碍存在睡眠异常。然而，这是第一个在自然环境下，将已缓解的双相情感障碍受试者与对照者在活动图和主观睡眠参数上进行5晚比较的研究。方法：纳入19名I型双相情感障碍患者和19名年龄和性别匹配的健康对照。目的采用腕动仪估计睡眠参数。受试者的睡眠日记和情绪评分也被完成。对每个受试者夜间的睡眠数据取平均值，并计算原始得分标准差，作为受试者内部可变性的衡量标准。结果：多变量方差分析发现，活动测量（F(4,33)=3.80， P=0.012）和主观测量（F(4,31)=3.18， P=0.027）组间差异显著。单变量分析确定了睡眠开始潜伏期（主观）、睡眠持续时间（主观）以及睡眠持续时间和夜间醒来时间（活动图）的可变性的可靠差异。二元向后逐步逻辑回归表明，在84%的病例中，三种睡眠测量方法的结合正确地预测了障碍状态。限制：社会人口统计和就业状况不匹配是一个限制，可能为一些研究结果提供另一种解释。此外，在双相情感障碍组中，19名受试者中有18人正在接受精神药物治疗，而健康对照组则没有。同时，控制组没有记录有关精神障碍家族史的信息。结论：研究表明，在自然环境中测量的躁郁症门诊患者的睡眠特征与对照组不同：躁郁症患者睡眠时间更长，报告的发作潜伏期更长，并且在夜间表现出更大的变异性。(C) 2003 Elsevier B.V.版权所有
Background: Several sleep laboratory studies suggest sleep abnormalities in bipolar disorder. However, this is the first study to compare remitted bipolar subjects with controls on actigraphic and subjective sleep parameters in a naturalistic setting over 5 nights. Methods: Nineteen subjects with Bipolar I Disorder and 19 age- and gender-matched healthy controls were included. Objective sleep parameters were estimated using wrist actigraphs. Subject-rated sleep diaries and mood ratings were also completed. Sleep data were averaged for each subject across nights, and raw score standard deviations were calculated as a measure of within-subject variability. Results: Multivariate analyses of variance found significant group differences for both actigraphic (F(4,33)=3.80, P=0.012) and subjective measures (F(4,31)=3.18, P=0.027). Univariate analyses identified reliable differences in sleep onset latency (subjective), sleep duration (subjective), and variability of sleep duration and night wake time (actigraphic). Binary backward stepwise logistic regression demonstrated that a combination of three sleep measures correctly predicted disorder status in 84% of cases. Limitations: Failure to match on sociodemographic and employment status is a limitation that may provide an alternative explanation for some findings. Furthermore, in the bipolar group 18 of 19 subjects were in receipt of psychotropic medication, compared to none of the healthy control group. Also, no information was recorded about family history of mental disorders in the control group. Conclusions: The study suggests that the sleep of remitted bipolar outpatients measured in naturalistic settings is characteristically different from controls: bipolar subjects sleep longer, report longer onset latencies, and display greater variability across nights. (C) 2003 Elsevier B.V. All rights reserved.