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Aug 8

The Sleep-Symptom Connection in Bipolar

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Psychological conditions can be intensified by life stressors, traumatic experiences, and interpersonal conflicts. Lack of sleep can also increase the symptoms of mental health problems. Additionally, sleep problems can indicate the presence of psychological illnesses such as depression and anxiety. Researchers have studied the effects of poor sleep patterns on mental and physical health for many years. But there have been few studies that have focused on how sleep fluctuates during nonsymptomatic periods. For instance, individuals with bipolar experience episodes of positive and negative affect but also go through periods when their moods are relatively stable. Although sleep patterns may be quite volatile in the presence of symptoms, few studies have looked at how interepisode sleep cycles affect symptom severity and the onset of future episodes.

To address this gap in research, Anda Gershon of the Department of Psychiatry and Behavioral Sciences at Stanford University recently conducted a study that examined the sleep patterns of 32 individuals with bipolar for 8 weeks. The participants were classified as interepisode at the time of the study and were assessed daily for affect, symptom severity, and sleep behaviors. Gershon looked specifically at how particular aspects of sleep, such as sleep onset and sleep quality, differed from a sample of 36 individuals with no history of bipolar.

Gershon found that the individuals with bipolar had more sleep disturbances than the controls. The clinical participants had more difficulty falling asleep and woke more during the night. They also stayed awake longer when they woke and had more trouble going back to sleep. The bipolar group demonstrated higher rates of negative affect than the controls. However, when affect was analyzed on the basis of sleep cycles, it was found that sleep impairment led to negative affect equally in both groups. Gershon believes that sleep is critical to the management of symptoms of bipolar during symptom flare ups and even interepisode. Gershon added, “Ongoing monitoring of sleep-affect coupling may provide an important target for intervention in bipolar disorder.”



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