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Subjective versus objective evening chronotypes in bipolar disorder.

Anda Gershon1, Christopher N Kaufmann2, Colin A Depp2

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People with bipolar disorder (BD) show later sleep timing than controls, with both subjective and objective measures aligning. This suggests objective sleep assessments can confirm later chronotypes in BD.

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Area of Science:

  • Psychiatry
  • Sleep Medicine
  • Chronobiology

Background:

  • Disturbed sleep timing is a frequent issue in bipolar disorder (BD).
  • Previous research predominantly relied on self-reported sleep patterns.
  • The relationship between subjective and objective sleep timing assessments in BD remains underexplored.

Purpose of the Study:

  • To investigate the correlation between subjective and objective measures of sleep timing in individuals with bipolar disorder (BD) and healthy controls.
  • To determine if objective sleep timing differs between BD patients and controls.

Main Methods:

  • Sixty-one individuals with bipolar I or II disorder and 61 healthy controls participated.
  • Subjective chronotype was assessed using the Composite Scale of Morningness (CSM) questionnaire.
  • Objective chronotype was determined using actigraphy data over 25-50 days, analyzing sleep interval midpoints.

Main Results:

  • Bipolar disorder participants exhibited significantly later chronotypes than controls when using modified CSM thresholds and objective measures (75% of sleep intervals after 4:15 a.m.).
  • Subjective and objective chronotype assessments showed a significant positive correlation in individuals with BD.
  • A high degree of concordance (≥95%) in evening chronotype classification between subjective and objective measures required at least 21 consecutive intervals.

Conclusions:

  • Subjective and objective chronotype measurements are correlated in individuals with bipolar disorder.
  • Objective assessments, using population-specific thresholds, confirm a later chronotype in BD patients compared to controls.