Sleep alterations in pediatric bipolar disorder versus attention deficit disorder (original) (raw)
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BMC psychiatry, 2017
Impairment of sleep and circadian rhythm is a typical feature of bipolar disorder (BD). We carried out an exploratory cross-sectional case-control study to extend the knowledge of sleep characteristics in offspring at risk for BD. We investigated 42 offspring of bipolar parents (OB) (mean age 12.5 ± 3.2) and 42 sex and age matched comparison offspring of healthy parents. We administered the Pediatric Sleep Questionnaire, the Morningness/Eveningness Questionnaire and The General Behavior Inventory Sleep Subscale (GBISS) to assess circadian preference, and to identify sleep impairment symptoms. In addition, the participants completed 14 days of actigraphy to characterise sleep and wake patterns. The current psychopathology profile was assessed using Kiddie Schedule for Affective Disorders and Schizophrenia. Prevalence of sleep disturbance symptoms was higher among OB than controls (headache after waking up, 17.9% vs. 2.4%, p = 0.03; excessive daytime sleepiness, 38.5% vs. 10.0%, p = 0...
Sleep Disturbances in Pediatric Bipolar Disorder: A Comparison between Bipolar I and Bipolar NOS
Frontiers in Psychiatry, 2012
Introduction:The diagnosis of bipolar disorder (BD) in youths has been controversial, especially for the subtype BD not otherwise specified (BD-NOS). In spite of growing evidence that sleep is a core feature of BD, few studies characterize and compare sleep disturbances in youth with BD type I (BD-I) and BD-NOS. Sleep disturbances are frequently reported in clinical descriptions of children and adolescents with BD, however the reporting of the frequency and characteristics of sleep symptoms in youth with BD-NOS and BD-I during episodes remain poor. This study compares symptom of sleep disturbance as occurring in manic and depressive episodes in BD-I and BD-NOS youth using Kiddie-schedule for affective disorders and schizophrenia, present and lifetime version (K-SADS-PL) interview data. The study also addresses whether symptoms of sleep disturbance vary in different age groups. Materials and Methods: The sample consisted of 70 children and adolescent outpatients at an urban specialty clinic (42M/28F, 10.8 ± 3.6 years old) including 24 BD-I and 46 BD-NOS assessed using K-SADS-PL-parent interview. Results: Sleep disturbances including insomnia and decreased need for sleep were reported by 84.3% of the sample. Enuresis was diagnosed in 27% of sample. There were no significant differences in frequency of sleep symptoms between BD-I and BD-NOS. Regardless of BD subtype, current functioning was negatively correlated with decreased need for sleep but not insomnia, and regardless of BD subtype. Conclusion:The majority of youth with BD presents with sleep symptoms during mood episodes. BD-NOS presents with the same proportion of sleep symptoms as BD-I in our sample.
Sleep in Adolescents With Bipolar I Disorder: Stability and Relation to Symptom Change
Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 2016
Sleep disturbances are common features of bipolar disorder (BD), yet little is known about trajectories of sleep disturbances in youth with BD. Using longitudinal data, this study assessed the stability of sleep disturbances and their ability to predict symptom progression in adolescents diagnosed with BD compared to controls. Thirteen- to 19-year-olds meeting diagnostic criteria for BD I (n = 19, 16.2 ± 1.75 years, 57.9 % female, 68.4% Caucasian) and psychiatrically healthy age-comparable controls (n = 21, 15.7 ± 1.48 years. 52.4% female, 57.1% Caucasian) were assessed for sleep onset latency, number of awakenings, and wake time, separately for weekdays and weekends using a self-report questionnaire. Sleep indices and symptoms of mania (Young Mania Rating Scale) and depression (Children's Depression Rating Scale) were assessed at two time points, T1 and T2, approximately 12 months apart. Correlations were used to examine stability of sleep indices across time points and regress...
Sleep disturbance is a salient symptom of pediatric bipolar disorder (BD). Common sleep problems in pediatric BD include decreased need for sleep, nighttime awakening, and hypersomnia (Kowatch et al., 2005; Lunsford-Avery et al., 2012). However, BD course, outcomes, and symptoms differ with age and gender (Rasgon et al., 2005; Altshuler et al., 2010). We hypothesize that sleep disturbance incrementally predicts BD diagnosis after controlling for age and gender. Of 746 outpatient youths (age 5-17), 131 met DSM-IV criteria for BD based on K-SADS diagnostic interviews with caregivers and youths. Caregivers completed the Child Behavior Checklist (CBCL; Achenbach, 2001; 6 sleep items) and the General Behavior Inventory (GBI; Depue et al., 1981; 7 sleep items). Binary logistic regressions assessed the relationship between sleep disturbance and BD after controlling for the effects of age and gender. Sleep disturbance significantly predicted BD diagnosis after controlling for age and gender...
Sleep and circadian rhythms in children and adolescents with bipolar disorder
Development and Psychopathology, 2006
The aim of this paper is to highlight the importance of the sleep-wake cycle in children and adolescents with bipolar disorder. After presenting an overview of the measurement and function of human sleep, we describe changes in sleep and circadian functioning across the life cycle. We then review evidence that, in adults, sleep and0or circadian rhythms are of considerable influence in the multifactorial causal chain implicated in relapse in bipolar disorder, discussing relevant mechanisms. The latter include abnormalities in the amount and timing of sleep, the role of social zeitgebers, and the importance of sleep in regulating emotional responses and mood. We next present preliminary data indicating considerable sleep disturbance among children and adolescents with bipolar disorder. Given the considerable sleep disturbance evident among children and adolescents with bipolar disorder along with a key role for sleep in emotion regulation and learning, we conclude that sleep among children and adolescents with bipolar disorder is a critical domain for future research. An agenda for future research is presented that includes descriptive studies, investigations of causality, and treatment development research.
Longitudinal sleep phenotypes among offspring of bipolar parents and community controls
Journal of affective disorders, 2017
Sleep disturbances are a prominent feature of bipolar disorder (BP). However, it remains unclear how sleep phenotypes may evolve among at-risk youth, and their relevance to BP onset. Pittsburgh Bipolar Offspring Study (BIOS) offspring (ages 10-18) and their parents completed assessments approximately every two years pertaining to current psychopathology and offspring sleep habits. A latent transition analysis (LTA) identified latent sleep groups within offspring based on their ratings of six sleep domains using the School Sleep Habits Survey. Demographic and clinical characteristics were compared between sleep groups. Logistic regression tested links between sleep group and BP onset at the subsequent assessment. The LTA model identified latent groups of good, poor, and variable sleepers. We observed an overall trend of good sleep becoming variable, and then poor, as youth age. Offspring in the poor sleep group were more likely to have psychopathology. Adjusting for age and depressio...
Web Survey of Sleep Problems Associated with Early-onset Bipolar Spectrum Disorders
Objective As research on sleep difficulties associated with Early-Onset Bipolar Spectrum Disorders (EBSD) is limited, a web-based survey was developed to further explore these problems. Methods 494 parents of 4-to-12 year-olds, identified by parents as being diagnosed with EBSD, completed a web survey about past and current EBSD-related sleep problems. The survey included Children's Sleep Habits Questionnaire (CSHQ) items and sleep problems from the International Classification of Sleep Disorders 2nd edition. Results Nearly all parents reported some type of past or current EBSD-sleep problem. Most occurred during a worst mood period, particularly with mixed manic-depressive symptoms. Symptoms caused impairments at home, school, or with peers in 96.9% of the sample and across all three contexts in 64.0% of children. Sleep problems were also noted after three-day weekends and Spring and Fall Daylight Savings time changes. Conclusions Findings, study limitations, and implications for treatment and etiology are discussed.