The Relationship Between Sleep Disturbance and Diagnosis of Bipolar Disorder: Testing Incremental Effect after Controlling for Age and Gender (2015)
Undergraduates: Yen-Ling Chen, Tate Halverson, Mian-Li Ong
Faculty Advisor: Eric Youngstrom
Department: Psychology & Neuroscience
Sleep disturbance is a salient symptom of pediatric bipolar disorder (BD). Common sleep problems in pediatric BD include decreased need for sleep, nighttime awakening, and hypersomnia (Roybal et al., 2011; Lunsford-Avery et al., 2012). However, BD course and outcomes differ with age and gender (Rasgon et al., 2005; Altshuler et al., 2010). We hypothesize that sleep disturbance incrementally predicts BD diagnosis even after controlling for age and gender.
Out of 746 outpatient youths (age 5-17), 153 met DSM-IV criteria for BD based on K-SADS diagnostic interviews with them and their primary caregivers. Caregivers completed the Child Behavior Checklist (CBCL; Achenbach, 2001; 6 sleep items) and the General Behavior Inventory (GBI; Depue et al., 1981; 7 sleep items).
Binary logistic regressions assessed the relationship between sleep disturbance and BD after controlling for the effects of age and gender. Sleep disturbance significantly predicted BD diagnosis after controlling for age and gender (GBI: OR = 1.2; CBCL: OR = 1.2; ps <.0005). Results from two widely used instruments suggest that sleep disturbance plays an important role in pediatric BD. Limitations include sole reliance on caregiver report of sleep disturbance. Future research could add objective measures of sleep, such as actigraphy. Sleep¿¿¿s strong association with bipolar diagnoses supports the value of investigating treatments that work to stabilize sleep and activity (Harvey et al., 2015).