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The association between sleep spindles and cognitive performance in euthymic bipolar disorder
Anna Tröger1,2, Jules Schneider3, Dimosthenis Tsapekos4
1Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. anna.troeger@kcl.ac.uk.
Translational Psychiatry
|July 14, 2026
Summary
Fast sleep spindles may be linked to working memory in bipolar disorder (BD). Lithium intake might influence this relationship, but more research is needed to confirm findings in BD cognitive deficits.
Area of Science:
- Neuroscience
- Psychiatry
- Sleep Medicine
Background:
- Bipolar disorder (BD) is frequently associated with persistent cognitive deficits, impacting daily functioning.
- Sleep spindles, crucial for memory consolidation, have shown alterations in various neurological and psychiatric conditions.
- The direct link between specific sleep spindle characteristics and cognitive performance in euthymic BD individuals remains underexplored.
Purpose of the Study:
- To investigate the association between fast sleep spindle density and episodic memory in euthymic individuals with BD.
- To explore relationships between fast and slow spindle density, subjective sleep quality, and other cognitive domains.
- To examine the influence of lithium intake on these sleep spindle-cognition associations.
Main Methods:
- Thirty-four euthymic participants with BD underwent cognitive assessments.
- Mobile sleep-electroencephalography (EEG) headbands were used for three nights to record sleep spindles.
- Validated algorithms detected and characterized fast and slow sleep spindle density.
Main Results:
- Fast spindle density was not significantly associated with episodic memory.
- A significant positive association was found between fast spindle density and working memory performance.
- Sensitivity analyses indicated potential lithium-related modulation of spindle-cognition relationships, though the study was underpowered.
Conclusions:
- Findings suggest a domain-specific relationship between sleep spindle activity and cognition in BD, particularly linking fast spindles to working memory.
- Lithium intake may play a role in modulating these associations, highlighting the need to consider pharmacological factors.
- Larger-scale studies are required to validate these preliminary findings and enhance understanding of sleep-cognition interplay in BD.
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