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Sleep Activity Patterns and Temperature in Childhood Onset Bipolar Disorder

儿童期发作的双相情感障碍的睡眠活动模式和温度

基本信息

批准号：
7682194
负责人：
PATRICIA J MURPHY
金额：
$ 15.25万
依托单位：
WEILL MEDICAL COLL OF CORNELL UNIV
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-09-05 至 2011-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7682194
关键词：
Adult Age Behavior Disorders Biological Bipolar Disorder Body Temperature Child Childhood Circadian Rhythms Classification Clinical Cognitive Comorbidity Consensus DSM-IV Data Data Collection Development Diagnosis Disease Distal Etiology Evaluation Exhibits Family Heating Home environment Hour Hyperactive behavior Intervention Studies Investigation Lead Light Light Exercise Maintenance Manic Measures Melatonin Mental disorders Monitor Mood Disorders Nature Parasomnias Parents Patients Pattern Phase Phototherapy Physiological Population Regulation Relative (related person)Reporting Rest Salivary Sampling Severities Skin Temperature Sleep Sleep Disorders Sleep disturbances Subgroup Symptoms Target Populations Techniques Technology Temperature Testing Therapeutic Time Wakefulness Wireless Technology actigraphy base childhood bipolar disorder early onset effective therapy experience impression monitoring device novel psychotic mania public health relevance sex sleep onset sleep onset insomnia sleep regulation social

项目摘要

DESCRIPTION (provided by applicant): Sleep and circadian rhythm disturbances are common features of bipolar disorder. Childhood onset bipolar disorder (COBD), in particular, is characterized by symptoms suggestive of altered regulation of sleep and wakefulness. An associated clinical observation is that children with bipolar disorder exhibit problems with heat dissipation. Despite the pervasiveness of parental complaints and frequent clinical observations of these issues, there are few studies of sleep and rest/activity patterns in COBD, and data relating to body temperature in COBD are virtually non-existent. It is likely that methodological complexities of obtaining such data in children with psychiatric disorders is a primary reason for the lack of studies of this nature. In addition, the very concept of early onset bipolar disorder has been controversial, and only in the last decade have empirical investigations targeting this population been conducted. Recent findings support the classification of COBD as a condition that shares many similarities with, yet is different in important ways, from adult onset bipolar disorder, and other childhood psychiatric disturbances. The aim of this R21 proposal is to evaluate whether nocturnal sleep, circadian and ultradian activity patterns, and thermoregulatory measures differ between children with bipolar disorder (who exhibit manic and psychotic symptoms) and healthy young controls. The study will take advantage of novel, non-invasive technology that enhances the feasibility of assessing sleep and rhythm parameters in children by using actigraphy and wireless temperature monitoring in a home-based study. We hypothesize that compared with controls, children with bipolar disorder will exhibit a phase delay of circadian activity and melatonin rhythms, a consistent ultradian pattern of morning hypoactivity and evening hyperactivity that manifests as enhanced amplitude of the daily activity rhythm, plus longer sleep onset latency and reduced sleep continuity. In addition, the skin temperature gradient measured before and following nocturnal sleep will differ in bipolar children relative to controls, providing evidence of altered heat dissipation. This exploratory project is viewed as an important step toward enhancing our understanding of the biological and physiological factors underlying COBD, and may provide empirical evidence of altered thermoregulatory and circadian regulation of sleep and wakefulness in children with the disorder. In doing so, it has the potential to inform intervention studies or identify novel treatment avenues for COBD, such as therapeutic cooling, exogenous melatonin administration, or timed light therapy. PUBLIC HEALTH RELEVANCE Children with bipolar disorder experience severe social, cognitive, and developmental consequences. The proposed exploratory study will assess sleep, circadian activity patterns, and temperature in this population with the aim of confirming the presence and severity of clinically observed and parent- reported sleep disturbance. The study will shed light on the etiology and biological underpinnings of the disorder, with the ultimate aim of identifying novel and effective treatment approaches for managing the sleep problems that contribute to the burden of bipolar disorder on both patients and their families.

描述（由申请人提供）：睡眠和昼夜节律紊乱是双相情感障碍的常见特征。尤其是儿童期发作的双相情感障碍（COBD），其特征是暗示睡眠和觉醒调节改变的症状。相关的临床观察结果是，患有双相情感障碍的儿童表现出散热问题。尽管家长的抱怨普遍存在，并且对这些问题的临床观察也很频繁，但对 COBD 的睡眠和休息/活动模式的研究很少，而且与 COBD 体温相关的数据几乎不存在。在患有精神疾病的儿童中获取此类数据的方法的复杂性很可能是缺乏此类研究的主要原因。此外，早发性双相情感障碍的概念一直存在争议，直到最近十年才针对这一人群进行了实证研究。最近的研究结果支持将 COBD 分类为一种与成人发病的双相情感障碍和其他儿童精神障碍有许多相似之处，但在重要方面有所不同的疾病。该 R21 提案的目的是评估患有双相情感障碍（表现出躁狂和精神病症状）的儿童与健康年轻对照组之间的夜间睡眠、昼夜节律和超昼夜活动模式以及体温调节措施是否存在差异。该研究将利用新颖的非侵入性技术，通过在家庭研究中使用体动记录仪和无线温度监测来提高评估儿童睡眠和节律参数的可行性。我们假设，与对照组相比，双相情感障碍儿童将表现出昼夜节律活动和褪黑激素节律的相位延迟，早晨活动不足和晚上活动过度的一致超昼夜模式，表现为日常活动节律幅度增强，加上入睡潜伏期更长和睡眠连续性降低。此外，双相情感障碍儿童在夜间睡眠前后测量的皮肤温度梯度相对于对照组有所不同，这提供了散热改变的证据。这一探索性项目被认为是增强我们对 COBD 背后的生物和生理因素的理解的重要一步，并且可能提供患有该疾病的儿童的体温调节和睡眠和觉醒的昼夜节律调节改变的经验证据。在此过程中，它有可能为干预研究提供信息或确定 COBD 的新治疗途径，例如治疗性降温、外源性褪黑激素给药或定时光疗。公共卫生相关性患有双相情感障碍的儿童会经历严重的社会、认知和发育后果。拟议的探索性研究将评估该人群的睡眠、昼夜节律活动模式和体温，目的是确认临床观察到的和家长报告的睡眠障碍的存在和严重程度。该研究将揭示该疾病的病因学和生物学基础，最终目的是确定新颖有效的治疗方法来管理睡眠问题，这些问题会加重双相情感障碍患者及其家人的负担。