Associations between comorbid anxiety and sleep disturbance in people with bipolar disorder: Findings from actigraphy and subjective sleep measures

Oakes, Daniel J., Pearce, Holly A. ORCID: https://orcid.org/0000-0003-2771-003X, Roberts, Cerian, Gehrman, Phillip G., Lewis, Catrin ORCID: https://orcid.org/0000-0002-3818-9377, Jones, Ian ORCID: https://orcid.org/0000-0001-5821-5889 and Lewis, Katie J. 2022. Associations between comorbid anxiety and sleep disturbance in people with bipolar disorder: Findings from actigraphy and subjective sleep measures. Journal of Affective Disorders 309 , pp. 165-171. 10.1016/j.jad.2022.04.065

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Abstract

Background Studies show that comorbid anxiety disorders are common in people with bipolar disorder. However, little is known about whether this anxiety is associated with sleep disturbance. We investigated, in individuals with bipolar disorder, whether comorbid anxiety disorder is associated with sleep disturbance. Methods Participants were 101 (64% female) currently euthymic individuals with a history of bipolar disorder. Sleep disturbances were assessed using self-report measures of sleep quality (Pittsburgh Sleep Quality Index, PSQI) and six weeks of sleep monitoring using actigraphy. Bipolar disorder and comorbid anxiety diagnoses were assessed using the Mini International Neuropsychiatric Interview. Multiple regression analyses examined associations between comorbid anxiety and sleep disturbance, whilst controlling for confounding covariates known to impact on sleep. Results A comorbid anxiety disorder was associated with increased sleep disturbance as measured using the PSQI global score (B = 3.58, 95% CI 1.85–5.32, P < 0.001) but was not associated with sleep metrics (total sleep time, sleep onset latency, sleep efficiency, and wake after sleep onset) derived using actigraphy. Limitations Objective measures of sleep were limited to actigraphy, therefore we were not able to examine differences in sleep neurophysiology. Conclusions Clinicians should be aware that comorbid anxiety may increase the risk of experiencing subjective sleep disturbance in people with bipolar disorder. Research should assess for evidence of comorbid anxiety when examining associations between sleep and bipolar disorder. Future research should explore the mechanisms by which comorbid anxiety may contribute to subjective sleep disturbances in bipolar disorder using neurophysiological measures of sleep (i.e., polysomnography).

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	National Centre for Mental Health (PNCMH) Medicine MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Publisher:	Elsevier
ISSN:	0165-0327
Funders:	Wellcome Trust
Date of First Compliant Deposit:	25 April 2022
Date of Acceptance:	10 April 2022
Last Modified:	21 Nov 2024 21:00
URI:	https://orca.cardiff.ac.uk/id/eprint/149322

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