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[Do sleep abnormalities contribute to cardiovascular risk in bipolar disorders?]
J-A Micoulaud Franchi1, P-A Geoffroy2, M Cermolacce3
1Laboratoire de Neurosciences Cognitives (LNC), UMR CNRS 7291, 31 Aix-Marseille Université, 13331 Marseille cedex 3, France.
Objectives:
The aim of this review is to summarize the state of knowledge concerning the relationship between cardiovascular risk, sleep abnormalities, and emotional reactivity in patients with bipolar disorder (BD).
Method:
A scientific literature search of international articles was performed during August and September 2014 using the PubMed electronic database. We used the following MeSH terms : "Bipolar Disorders", "Cardiovascular risk", "Emotional reactivity", "Sleep apnea", and "Sleep disorder".
Results:
Obstructive sleep apnea (OSA) is a sleep disorder strongly associated with BD, which tends to fragment sleep. OSA is associated with an increased cardiovascular risk. Furthermore, emotional hyper-reactivity is favored by "hostility" temperaments, BD and sleep deprivation. The combination of these factors interacts and also results in an increased cardiovascular risk. Taken as a whole, both sleep disorders and emotional hyper-reactivity seem to increase the risk of cardiovascular diseases in BD.
Conclusion:
These data emphasize the central role of sleep abnormalities and emotional reactivity in the vulnerability of BD to express cardiovascular diseases. From a clinical point of view, these data also emphasize the importance of identifying and care for sleep abnormalities in BD in order to improve BD outcome.
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