The Relationship Between Sleep Quality and Prodromal Symptoms in Euthymic Patients with Bipolar Disorder

Although sleep quality is known to be impaired in individuals diagnosed with bipolar disorder (BD) during manic, depressive, and even euthymic phases, limited research has explored its association with prodromal symptoms. This study aims to investigate the relationship between sleep quality and the frequency and severity of prodromal symptoms in patients diagnosed with bipolar disorder during euthymic periods.

The study included 98 patients with euthymic BD in remission. The participants completed the sociodemographic data form, Pittsburgh Sleep Quality Index (PSQI), Bipolar Prodrome Symptom Scale (BPSS), Young Mania Rating Scale (YMRS), and Hamilton Depression Rating Scale (HDRS).

The mean age of the patients was 42.20 ± 11.902. In the patient group with PSQI score>5, BPSS-frequency and BPSS-severity scores were found to be significantly higher (p<0.05). Both BPSS-frequency and severity scores showed significant positive correlations with PSQI scores (p<0.001), and BPSS-frequency score was positively correlated with HDRS scores (p<0.05). No significant differences were observed in BPSS, HDRS, or YMRS scores according to the duration of the disorder (p>0.05).

Based on the findings of our study, we conclude that as sleep quality deteriorates during the euthymic phase in patients with BD, the frequency and severity of prodromal symptoms also increase. It is suggested that sleep disturbances in this patient population should be closely monitored even during the euthymic period, as sleep disorders themselves may serve as prodromal symptoms and potentially exacerbate the onset of other prodromal manifestations. Therefore, detailed assessment of sleep problems between episodes-and timely intervention when necessary-may be critical for early detection and prevention of mood episode relapse.