Sleep Medicine and Psychophysiology (수면정신생리)

KOREAN ACADEMY OF SLEEP MEDICINE (대한수면의학회)
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Sleep Disorders in Bipolar Disorders: A Narrative Review on Circadian Rhythm Disturbances and Sleep Apnoea

양극성 장애에서의 수면장애: 일주기 리듬의 교란과 수면 무호흡증을 중심으로

  • Junhee, Lee (Department of Psychiatry, Eulji University and Uijeonbgu Eulji Medical Center) ;
  • Sanghoon, Oh (Department of Psychiatry, Eulji University and Uijeonbgu Eulji Medical Center)
  • 이준희 (을지대학교 의과대학 정신과학교실) ;
  • 오상훈 (을지대학교 의과대학 정신과학교실)
  • Received : 2022.12.25
  • Accepted : 2022.12.30
  • Published : 2022.12.31
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Abstract

Bipolar disorders are a group of mood disorders characterised by relapsing mood episodes throughout the course of illness. Patients with bipolar disorders commonly present with various sleep problems. Patients in a manic episode generally show decreased need of sleep and those in a depressed episode frequently complain about hypersomnia. Current literature even points to evidence that patients with bipolar disorder in euthymic state may still show signs of sleep disturbances when compared to the general population. Clinicians may also note intricate interactions between changes of circadian rhythm and evolution of mood episodes in patients with bipolar disorder. Also, commonly prescribed medications which plays a crucial role in treatment of bipolar disorders including mood stabilisers and antipsychotic medications often cause significant weight gain over time. Being a risk factor of sleep apnoea, weight gain can predispose the patient to develop sleep apnoea. In this narrative review, we summarised current evidence and literature regarding characteristics of circadian rhythm and comorbid sleep apnoea in patients with bipolar disorder. We also present literature regarding implications of circadian disturbance and comorbid sleep apnoea in managing patients with bipolar disorder.

Keywords

References

  1. Abreu T, Braganca M. The bipolarity of light and dark: a review on Bipolar Disorder and circadian cycles. Journal of Affective Disorders 2015;185:219-229. https://doi.org/10.1016/j.jad.2015.07.017
  2. Ahn YM, Chang J, Joo YH, Kim SC, Lee KY, Kim YS. Chronotype distribution in bipolar I disorder and schizophrenia in a Korean sample. Bipolar Disord 2008;10:271-275. https://doi.org/10.1111/j.1399-5618.2007.00573.x
  3. Alloy LB, Boland EM, Ng TH, Whitehouse WG, Abramson LY. Low social rhythm regularity predicts first onset of bipolar spectrum disorders among at-risk individuals with reward hypersensitivity. J Abnorm Psychol 2015;124:944-952. https://doi.org/10.1037/abn0000107
  4. American Psychiatric Association. Diagnostic and statistical manual of mental disorders : DSM-5, 5th Ed, 2013 American Psychiatric Association, Washington, D.C.
  5. Bauer M, Grof P, Rasgon N, Bschor T, Glenn T, Whybrow PC. Temporal relation between sleep and mood in patients with bipolar disorder. Bipolar Disord 2006;8:160-167. https://doi.org/10.1111/j.1399-5618.2006.00294.x
  6. Benedetti F, Riccaboni R, Dallaspezia S, Locatelli C, Smeraldi E, Colombo C. Effects of CLOCK gene variants and early stress on hopelessness and suicide in bipolar depression. Chronobiol Int 2015;32:1156-1161. https://doi.org/10.3109/07420528.2015.1060603
  7. Benedetti F, Riccaboni R, Locatelli C, Poletti S, Dallaspezia S, Colombo C. Rapid treatment response of suicidal symptoms to lithium, sleep deprivation, and light therapy (chronotherapeutics) in drug-resistant bipolar depression. The Journal of Clinical Psychiatry 2014;75:133-140. https://doi.org/10.4088/JCP.13m08455
  8. Benedetti F, Serretti A, Colombo C, Barbini B, Lorenzi C, Campori E, et al. Influence of CLOCK gene polymorphism on circadian mood fluctuation and illness recurrence in bipolar depression. Am J Med Genet B Neuropsychiatr Genet 2003;123B:23-26. https://doi.org/10.1002/ajmg.b.20038
  9. Bersani G, Garavini A. Melatonin add-on in manic patients with treatment resistant insomnia. Prog Neuropsychopharmacol Biol Psychiatry 2000;24:185-191. https://doi.org/10.1016/S0278-5846(99)00097-4
  10. Chengappa KN, Chalasani L, Brar JS, Parepally H, Houck P, Levine J. Changes in body weight and body mass index among psychiatric patients receiving lithium, valproate, or topiramate: an open-label, nonrandomized chart review. Clin Ther 2002;24:1576-1584. https://doi.org/10.1016/S0149-2918(02)80061-3
  11. Cho CH, Lee HJ. Why do mania and suicide occur most often in the spring? Psychiatry Investigation 2018;15:232-234. https://doi.org/10.30773/pi.2017.12.20
  12. Dallaspezia S, Benedetti F. Melatonin, circadian rhythms, and the clock genes in bipolar disorder. Curr Psychiatry Rep 2009;11:488-493. https://doi.org/10.1007/s11920-009-0074-1
  13. Eckert DJ, Jordan AS, Merchia P, Malhotra A. Central sleep apnea: pathophysiology and treatment. Chest 2007;131:595-607. https://doi.org/10.1378/chest.06.2287
  14. Ehlers CL. Social zeitgebers, biological rhythms and depression. Clin Neuropharmacol 1992;15 Suppl 1 Pt A:44A-45A. https://doi.org/10.1097/00002826-199201001-00025
  15. Epstein LJ, Kristo D, Strollo PJ Jr, Friedman N, Malhotra A, Patil SP, et al. Clinical guideline for the evaluation, management and longterm care of obstructive sleep apnea in adults. J Clin Sleep Med 2009;5:263-276. https://doi.org/10.5664/jcsm.27497
  16. Giglio LM, Magalhaes PV, Andersen ML, Walz JC, Jakobson L, Kapczinski F. Circadian preference in bipolar disorder. Sleep Breath 2010;14:153-155.
  17. Harvey AG. Sleep and circadian rhythms in bipolar disorder: seeking synchrony, harmony, and regulation. The American Journal of Psychiatry 2008;165:820-829. https://doi.org/10.1176/appi.ajp.2008.08010098
  18. Henriksen TE, Skrede S, Fasmer OB, Schoeyen H, Leskauskaite I, Bjorke-Bertheussen J, et al. Blue-blocking glasses as additive treatment for mania: a randomized placebo-controlled trial. Bipolar Disord 2016;18:221-232. https://doi.org/10.1111/bdi.12390
  19. Kennedy SH, Kutcher SP, Ralevski E, Brown GM. Nocturnal melatonin and 24-hour 6-sulphatoxymelatonin levels in various phases of bipolar affective disorder. Psychiatry Research 1996;63:219-222. https://doi.org/10.1016/0165-1781(96)02910-1
  20. Kitamura S, Hida A, Watanabe M, Enomoto M, Aritake-Okada S, Moriguchi Y, et al. Evening preference is related to the incidence of depressive states independent of sleep-wake conditions. Chronobiol Int 2010;27:1797-1812. https://doi.org/10.3109/07420528.2010.516705
  21. Kripke DF, Mullaney DJ, Atkinson M, Wolf S. Circadian rhythm disorders in manic-depressives. Biological Psychiatry 1978;13:335-351.
  22. Lee HJ, Kim L, Joe SH, Suh KY. Effects of season and climate on the first manic episode of bipolar affective disorder in Korea. Psychiatry Research 2002;113:151-159. https://doi.org/10.1016/S0165-1781(02)00237-8
  23. Lee KY, Song JY, Kim SH, Kim SC, Joo EJ, Ahn YM, et al. Association between CLOCK 3111T/C and preferred circadian phase in Korean patients with bipolar disorder. Prog Neuropsychopharmacol Biol Psychiatry 2010;34:1196-1201. https://doi.org/10.1016/j.pnpbp.2010.06.010
  24. Linkowski P. Neuroendocrine profiles in mood disorders. The International Journal of Neuropsychopharmacology/Official Scientific Journal of the Collegium Internationale Neuropsychopharmacologicum 2003;6:191-197. https://doi.org/10.1017/S1461145703003407
  25. Mahmood S, Booker I, Huang J, Coleman CI. Effect of topiramate on weight gain in patients receiving atypical antipsychotic agents. Journal of Clinical Psychopharmacology 2013;33:90-94. https://doi.org/10.1097/JCP.0b013e31827cb2b7
  26. Malkoff-Schwartz S, Frank E, Anderson BP, Hlastala SA, Luther JF, Sherrill JT, et al. Social rhythm disruption and stressful life events in the onset of bipolar and unipolar episodes. Psychological Medicine 2000;30:1005-1016. https://doi.org/10.1017/S0033291799002706
  27. McClung CA. How might circadian rhythms control mood? Let me count the ways. Biological Psychiatry 2013;74:242-249. https://doi.org/10.1016/j.biopsych.2013.02.019
  28. Miron IC, Baroana VC, Popescu F, Ionica F. Pharmacological mechanisms underlying the association of antipsychotics with metabolic disorders. Curr Health Sci J 2014;40:12-17. https://doi.org/10.12865/CHSJ.40.01.02
  29. Muneer A. Mixed states in bipolar disorder: etiology, pathogenesis and treatment. Chonnam Med J 2017;53:1-13. https://doi.org/10.4068/cmj.2017.53.1.1
  30. Murray G, Harvey A. Circadian rhythms and sleep in bipolar disorder. Bipolar Disord 2010;12:459-472. https://doi.org/10.1111/j.1399-5618.2010.00843.x
  31. Ng TH, Chung KF, Ho FY, Yeung WF, Yung KP, Lam TH. Sleep-wake disturbance in interepisode bipolar disorder and high-risk individuals: a systematic review and meta-analysis. Sleep Med Rev 2015;20:46-58.
  32. Noguchi T, Lo K, Diemer T, Welsh DK. Lithium effects on circadian rhythms in fibroblasts and suprachiasmatic nucleus slices from Cry knockout mice. Neuroscience Letter 2016;619:49-53. https://doi.org/10.1016/j.neulet.2016.02.030
  33. Norris ER, Karen B, Correll JR, Zemanek KJ, Lerman J, Primelo RA, et al. A double-blind, randomized, placebo-controlled trial of adjunctive ramelteon for the treatment of insomnia and mood stability in patients with euthymic bipolar disorder. Journal of Affective Disorders 2013;144:141-147. https://doi.org/10.1016/j.jad.2012.06.023
  34. Novakova M, Prasko J, Latalova K, Sladek M, Sumova A. The circadian system of patients with bipolar disorder differs in episodes of mania and depression. Bipolar Disord 2015;17:303-314. https://doi.org/10.1111/bdi.12270
  35. Nurnberger JI Jr, Adkins S, Lahiri DK, Mayeda A, Hu K, Lewy A, et al. Melatonin suppression by light in euthymic bipolar and unipolar patients. Archives of General Psychiatry 2000;57:572-579. https://doi.org/10.1001/archpsyc.57.6.572
  36. Pamidi S, Tasali E. Obstructive sleep apnea and type 2 diabetes: is there a link? Front Neurol 2012;3:126. https://doi.org/10.3389/fneur.2012.00126
  37. Schumann SA, Ewigman B. Can metformin undo weight gain induced by antipsychotics? J Fam Pract 2008;57:526-530.
  38. Serretti A, Olgiati P. Profiles of "manic" symptoms in bipolar I, bipolar II and major depressive disorders. Journal of Affective Disorders 2005;84:159-166.
  39. Severus E, Bauer M. Diagnosing bipolar disorders in DSM-5. Int J Bipolar Disord 2013;1:14. https://doi.org/10.1186/2194-7511-1-14
  40. Sharafkhaneh A, Giray N, Richardson P, Young T, Hirshkowitz M. Association of psychiatric disorders and sleep apnea in a large cohort. Sleep 2005;28:1405-1411. https://doi.org/10.1093/sleep/28.11.1405
  41. Shen GH, Alloy LB, Abramson LY, Sylvia LG. Social rhythm regularity and the onset of affective episodes in bipolar spectrum individuals. Bipolar Disord 2008;10:520-529. https://doi.org/10.1111/j.1399-5618.2008.00583.x
  42. Shrivastava A, Johnston ME. Weight-gain in psychiatric treatment: risks, implications, and strategies for prevention and management. Mens Sana Monogr 2010;8:53-68. https://doi.org/10.4103/0973-1229.58819
  43. Singh T. Aripiprazole-induced weight gain. Psychiatry (Edgmont) 2005;2:19.
  44. Spicuzza L, Caruso D, Di Maria G. Obstructive sleep apnoea syndrome and its management. Ther Adv Chronic Dis 2015;6:273-285. https://doi.org/10.1177/2040622315590318
  45. Stansbury RC, Strollo PJ. Clinical manifestations of sleep apnea. Journal of Thoracic Disease 2015;7:E298-E310.
  46. Steinan MK, Scott J, Lagerberg TV, Melle I, Andreassen OA, Vaaler AE, et al. Sleep problems in bipolar disorders: more than just insomnia. Acta Psychiatr Scand 2016;133:368-377. https://doi.org/10.1111/acps.12523
  47. Sylvia LG, Alloy LB, Hafner JA, Gauger MC, Verdon K, Abramson LY. Life events and social rhythms in bipolar spectrum disorders: a prospective study. Behav Ther 2009;40:131-141. https://doi.org/10.1016/j.beth.2008.04.003
  48. Takaesu Y, Inoue Y, Ono K, Murakoshi A, Futenma K, Komada Y, et al. Circadian rhythm sleep-wake disorders predict shorter time to relapse of mood episodes in euthymic patients with bipolar disorder: a prospective 48-week study. The Journal of Clinical Psychiatry 2018;79.
  49. Terman M, Terman JS. Light therapy for seasonal and nonseasonal depression: efficacy, protocol, safety, and side effects. CNS Spectrums 2005;10:647-63; quiz 672. https://doi.org/10.1017/S1092852900019611
  50. Vadnie CA, McClung CA. Circadian rhythm disturbances in mood disorders: insights into the role of the suprachiasmatic nucleus. Neural Plast 2017;2017:1504507. https://doi.org/10.1155/2017/1504507
  51. Vieta E, Sanchez-Moreno J. Acute and long-term treatment of mania. Dialogues Clin Neurosci 2008;10:165-179. https://doi.org/10.31887/DCNS.2008.10.2/evieta
  52. Vitale JA, Roveda E, Montaruli A, Galasso L, Weydahl A, Caumo A, et al. Chronotype influences activity circadian rhythm and sleep: differences in sleep quality between weekdays and weekend. Chronobiol Int 2015;32:405-415. https://doi.org/10.3109/07420528.2014.986273
  53. Wehr TA, Turner EH, Shimada JM, Lowe CH, Barker C, Leibenluft E. Treatment of rapidly cycling bipolar patient by using extended bed rest and darkness to stabilize the timing and duration of sleep. Biological Psychiatry 1998;43:822-828. https://doi.org/10.1016/S0006-3223(97)00542-8
  54. Winkelman JW. Schizophrenia, obesity, and obstructive sleep apnea. The Journal of Clinical Psychiatry 2001;62:8-11. https://doi.org/10.4088/JCP.v62n0103
  55. Wirz-Justice A, Quinto C, Cajochen C, Werth E, Hock C. A rapid-cycling bipolar patient treated with long nights, bedrest, and light. Biological Psychiatry 1999;45:1075-1077. https://doi.org/10.1016/S0006-3223(98)00289-3
  56. Wood J, Birmaher B, Axelson D, Ehmann M, Kalas C, Monk K, et al. Replicable differences in preferred circadian phase between bipolar disorder patients and control individuals. Psychiatry Research 2009;166:201-209. https://doi.org/10.1016/j.psychres.2008.03.003