A mechanism of sleep disturbance in bipolar disorder

双相情感障碍睡眠障碍的机制

• 批准号: 7275754
• 负责人: Anda Gershon
• 金额: $ 4.68万
• 依托单位: UNIVERSITY OF CALIFORNIA BERKELEY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-06-01 至 2010-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7275754
• 关键词: American; Attention; Biological; Biological Clocks; Bipolar Disorder; Characteristics; Daily; Development; Disease; Disruption; Evaluation; Event; Functional disorder; Goals; Health Priorities; Individual; Influentials; Intervention; Interview; Knowledge; Life; Life Stress; Link; Literature; Maintenance; Manic; Measures; Mediating; Mental Depression; Methodology; Outcome; Outpatients; Pathway interactions; Patients; Prevention; Prevention strategy; Process; Psychosocial Factor; Public Health; Quality of life; Rate; Recurrence; Relapse; Reporting; Research; Risk; Role; Sampling; Sleep; Sleep Wake Cycle; Sleep disturbances; Stressful Event; Structure; Symptoms; Translational Research; Week; base; depressive symptoms; diaries; disability; experience; improved; innovation; prevent; programs; psychologic; social; theories; therapy design

DESCRIPTION (provided by applicant): Bipolar disorder is a severe and highly recurrent disorder that is ranked among the top 10 causes of disability worldwide. Despite remarkable advances in the treatment of bipolar disorder, studies consistently document alarmingly high rates of relapse, even among patients who receive, and adhere to, treatment. Additionally, bipolar patients continue to be symptomatic between episodes of illness. These high rates of relapse and continued dysfunction suggest the presence of an underlying process, or multiple processes, that render individuals with bipolar disorder vulnerable to the onset of new episodes of illness. An important public health priority is to identify these processes - a goal with profound implications for improving prevention and treatment intervention outcomes. Several lines of research converge to highlight sleep disturbance as a process of key importance in the onset of both depressive and manic symptoms, and thus in the maintenance of bipolar disorder among patients. To date, however, the pervasively poor sleep that is characteristic of bipolar disorder has received minimal empirical attention. Accordingly, the aim of the proposed research is to investigate a potential mechanism by which sleep is disturbed in bipolar disorder. This program of research provides the first direct empirical evaluation of a central causal mechanism posited by social zeitgeber theory, namely, that sleep disturbance in bipolar disorder is caused by disruptions in social rhythms, which can be triggered by stressful life events (Ehlers et al., 1988; Frank et al., 2000). Specifically, the aim of the proposed program of research is to examine whether sleep is disturbed following the experience of stressful events that disrupt social rhythms, in a sample of carefully screened euthymic bipolar outpatients and matched healthy controls. The occurrence and impact of life events, stability of social rhythms, and quality of sleep, will be measured prospectively over the course of an 8 week period using (1) a daily diary for the assessment of stressful events and stability of social rhythms, and (2) a continuously worn actigraph for the daily assessment of sleep-wake cycles and sleep quality. Semi-structured life stress interviews will be administered to assess subjective and objective impact of the events reported during the daily assessment period. This methodology will allow us to begin to delineate a potentially critical mechanism by which sleep may be disturbed in bipolar patients. The long-term goal of this research is to use the knowledge gained to facilitate translational research with the aim of developing new treatment and new prevention strategies that target sleep disturbance among bipolar patients.

描述(申请人提供)：双相情感障碍是一种严重且高度反复发作的疾病，被列为全球十大致残原因之一。尽管双相情感障碍的治疗取得了显著进展，但研究始终证明复发率高得惊人，即使在接受并坚持治疗的患者中也是如此。此外，双相情感障碍患者在两次发作之间仍有症状。这些高复发率和持续的功能障碍表明，存在一个潜在的过程，或多个过程，使双相情感障碍患者容易出现新的疾病发作。一个重要的公共卫生优先事项是确定这些进程--这一目标对改善预防和治疗干预结果具有深远影响。几条研究路线汇聚在一起，强调睡眠障碍是抑郁和躁狂症状出现的关键过程，从而在患者中维持双相情感障碍。然而，到目前为止，以双相情感障碍为特征的普遍糟糕的睡眠得到的经验关注很少。因此，这项拟议的研究的目的是调查双相情感障碍患者睡眠受到干扰的潜在机制。这一研究计划首次对社会时代理论提出的中心原因机制进行了直接的经验评估，即双相情感障碍的睡眠障碍是由社会节奏的中断引起的，而社会节奏的中断可以由应激性生活事件触发(Ehles等人，1988；Frank等人，2000)。具体地说，拟议的研究计划的目的是检查在经历了扰乱社会节奏的应激事件后，睡眠是否受到干扰，样本是经过仔细筛选的良性双相情感障碍门诊患者和匹配的健康对照组。生活事件的发生和影响、社会节律的稳定性和睡眠质量将在8周的过程中进行前瞻性测量，使用(1)用于评估应激事件和社会节律稳定性的每日日记，以及(2)用于每日评估睡眠-觉醒周期和睡眠质量的持续磨损的活动记录仪。将进行半结构化生活压力访谈，以评估在日常评估期间报告的事件的主观和客观影响。这一方法论将使我们能够开始描绘双相情感障碍患者睡眠可能受到干扰的潜在关键机制。这项研究的长期目标是利用所获得的知识促进转化研究，目的是开发针对双相患者睡眠障碍的新治疗和新预防策略。