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Abstract:
There is ample data suggesting that individuals with bipolar disorder
more frequently suffer from disturbed sleep even when euthymic. Since
sleep is a process that is crucial for affective homeostasis, disturbed
sleep in healthy individuals may be a risk factor for the subsequent
onset of bipolar disorder. Utilizing data from a large cohort of
adolescents and young adults, this study tests the hypothesis that
disturbed sleep constitutes a risk factor for the later onset of bipolar
disorder. A representative community sample of N = 3021 adolescents and
young adults (baseline age 14-24) was assessed using the standardized
Composite International Diagnostic Interview and followed-up
prospectively up to 3 times over up to 10 years. Disturbed sleep at
baseline was quantified utilizing the corresponding items from the
self-report inventory SCL-90-R. The compound value (insomnia-score) as
an ordinal parameter for the severity of sleep disturbances was used to
assess associations with the incidence of bipolar disorder among
participants free of major mental disorder at baseline (N = 1943) using
odds ratios (OR) from logistic regressions. Analyses were adjusted for
age, gender, parental mood disorder and lifetime alcohol or cannabis
dependence. Poor sleep quality significantly increased the risk for the
subsequent development of bipolar disorder (OR = 1.75; p = 0.001).
Regarding individual sleep items, trouble falling asleep and early
morning awakening were predictive for the subsequent onset of bipolar
disorder.
Disturbed sleep in persons otherwise free of major mental disorders
appears to confer an increased risk for the subsequent onset of bipolar
disorder. (C) 2015 Elsevier Ltd. All rights reserved.
