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Hypersomnia subtypes, sleep and relapse in bipolar disorder
K A Kaplan1, E L McGlinchey2, A Soehner3
1Department of Psychiatry,Stanford University School of Medicine,Stanford,CA,USA.
Psychological Medicine
|December 18, 2014
Summary
Hypersomnia in bipolar disorder presents as two distinct types: long sleep and excessive sleepiness. Excessive sleepiness predicts mood episode relapse, highlighting different clinical implications for these hypersomnia subtypes.
Area of Science:
- Psychiatry
- Sleep Medicine
- Bipolar Disorder Research
Background:
- Hypersomnia lacks clear definition, impacting research generalizability and association with adverse health and psychiatric outcomes.
- Existing research on hypersomnia in bipolar disorder is limited by definitional ambiguity.
- This study addresses the need to clarify hypersomnia diagnoses within bipolar disorder.
Purpose of the Study:
- To define and explore subgroups of hypersomnia in adults with bipolar spectrum diagnoses.
- To investigate the relationship between hypersomnia subgroups, objective sleep data, and mood episode relapse.
- To refine the understanding of hypersomnia classification and its associated morbidity.
Main Methods:
- A community sample of 159 adults with bipolar spectrum diagnoses, euthymic at baseline, was analyzed.
- Hypersomnia features were assessed using self-report inventories and clinician-administered interviews.
- Objective sleep data were collected via sleep diaries and wrist actigraphy, with psychiatric status reassessed after approximately 7 months.
Main Results:
- Factor analysis identified two uncorrelated hypersomnia subtypes: 'long sleep' and 'excessive sleepiness'.
- Latent profile analysis supported a four-class solution, with these two subtypes as distinct classes.
- Objective sleep data indicated 'long sleepers' have extended time in bed, not necessarily longer sleep duration.
- Baseline 'excessive sleepiness' predicted subsequent mania/hypomania relapse.
Conclusions:
- Hypersomnia in bipolar disorder comprises two distinct subgroups: long sleep and excessive sleepiness.
- 'Long sleep' is characterized by prolonged bedrest duration, while 'excessive sleepiness' is not linked to extended sleep.
- 'Excessive sleepiness' is a significant predictor of relapse into mania/hypomania.
- These findings have critical implications for research and clinical treatment of hypersomnia in bipolar disorder.
Keywords:
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