Background
Bipolar disorder (BD) is a lifelong, potentially treatable psychiatric disorder with
substantial morbidity and mortality. Sleep is a very important factor for the quality of
life, risk for relapse, affective functioning, cognitive functioning, impulsivity, and
general health. It is important to note that a bidirectional relationship likely exists
between sleep disturbance and mood disorders, as symptoms of mood disorders
may disrupt sleep, and disrupted sleep can increase symptoms of mood disorders.
Moreover, the sources of inflammation and immune activation, which play a role in
depression, may contribute to the inflammatory burden in patients with mania.
Aim
The aimof this study was to study the nature of sleep disturbance in bipolar patients AQ10
and to detect the correlation between the severity of BD and sleep disturbance.
Patients and methods; and results
In this case–control study, fifty BD patients (28 male patients and 22 female AQ11
patients) and 20 age-matched controls were recruited for this study. Structured
Clinical Interview for DSM-IV Axis I Disorders for diagnosis of BD; Beck Depression
Inventory-II and Young Mania Rating Scale (YMRS) were used to assess the
severity of BD. Assessment of sleep pattern was carried out by Pittsburgh Sleep
Quality Index (PSQI), and C-reactive protein (CRP) was measured. In the current
study, with regard to Beck scores before medication, there were inverse relations
with YMRS and PSQI. These relations become direct after medication. As regards
YMRS scores before medication, there was an inverse relation with Beck, direct
relations with PSQI, which did not show any change after medication, except for
sleep disturbance, which become an inverse relation. As regards PSQI’s total
scores before medication, it showed an inverse relation with Beck, direct relations
with YMRS and the relation with Beck scores became direct after medication. As
regards CRP levels, there was a significant difference between cases before and
after medication and significant difference between the case and control groups.
Conclusion
PSQI is a cheap valid test that can be used in Egypt to report sleep profile and
abnormalities, to follow-up the patients and prevent relapse. Hence, bipolar patients
with depressive symptoms improved and responded better on treatment, with better
improvement in sleep profile than patients with manic symptoms. Moreover, a
definite correlation between sleep disturbance and CRP levels could not be
concluded. |
