The dynamic interplay between sleep and mood: an intensive longitudinal study of individuals with bipolar disorder.
The dynamic interplay between sleep and mood: an intensive longitudinal study of individuals with bipolar disorder.
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DOI：
10.1017/s0033291721005377
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发表时间：
2023-06
影响因子：
6.9
通讯作者：
Heron, J.
中科院分区：
文献类型：
--
作者：
Lewis, K. J. S.;Tilling, K.;Gordon-Smith, K.;Saunders, K. E. A.;Di Florio, A.;Jones, L.;Jones, I;O'Donovan, M. C.;Heron, J.
关键词：
睡眠障碍是监测双相情感障碍（BD）患者的重要症状，但睡眠和情绪之间的确切纵向关系尚不清楚。我们的目的是研究双相障碍患者的稳定和动态睡眠与情绪之间的联系，并评估这些联系强度的个体差异。患有BD-I （N = 400）和BD-II （N = 249）的参与者（N = 649）每周使用True colors在线监测工具提供失眠、抑郁和（轻度）躁狂症状的自我报告，持续21个月。动态结构方程模型被用来检验每周失眠报告和情绪之间的相互作用。临床和人口学特征对关联的影响也进行了评估。失眠症状变异性的增加与情绪变异性的增加有关。在整个样本中，我们发现了失眠和抑郁症状之间双向关系的有力证据，但只有微弱的证据支持失眠和（轻度）躁狂症状之间的双向关系。我们发现受试者之间失眠和情绪之间的潜在关联强度存在很大差异，这取决于年龄、性别、双相情感障碍亚型和快速循环史。我们的研究结果强调了监测双相障碍患者睡眠的重要性。然而，研究人员和临床医生在调查睡眠和情绪之间的关系时，应该考虑这种关系的亚组差异。数字技术的进步意味着关于睡眠和情绪的大量纵向数据变得越来越容易获得。分析这些数据的新方法为进一步了解双相障碍提供了令人兴奋的机会。
Sleep disturbances are important symptoms to monitor in people with bipolar disorder (BD) but the precise longitudinal relationships between sleep and mood remain unclear. We aimed to examine associations between stable and dynamic aspects of sleep and mood in people with BD, and assess individual differences in the strength of these associations. Participants (N = 649) with BD-I (N = 400) and BD-II (N = 249) provided weekly self-reports of insomnia, depression and (hypo)mania symptoms using the True Colours online monitoring tool for 21 months. Dynamic structural equation models were used to examine the interplay between weekly reports of insomnia and mood. The effects of clinical and demographic characteristics on associations were also assessed. Increased variability in insomnia symptoms was associated with increased mood variability. In the sample as a whole, we found strong evidence of bidirectional relationships between insomnia and depressive symptoms but only weak support for bidirectional relationships between insomnia and (hypo)manic symptoms. We found substantial variability between participants in the strength of prospective associations between insomnia and mood, which depended on age, gender, bipolar subtype, and a history of rapid cycling. Our results highlight the importance of monitoring sleep in people with BD. However, researchers and clinicians investigating the association between sleep and mood should consider subgroup differences in this relationship. Advances in digital technology mean that intensive longitudinal data on sleep and mood are becoming increasingly available. Novel methods to analyse these data present an exciting opportunity for furthering our understanding of BD.