Association of insomnia with mania in Lebanese patients with bipolar disorder

Encephale. 2021 Aug;47(4):314-318. doi: 10.1016/j.encep.2020.09.008. Epub 2021 Feb 1.

Abstract

Objective: To assess: (1) the association between insomnia experienced at admission, sociodemographic and other patients' characteristics and mania; and (2) the variation of insomnia and mania before and after treatment in bipolar patients with manic episodes (type I).

Methods: Sixty-two patients were interviewed shortly after their admission to the hospital (after 3 to 5 days). The current symptoms experienced by the patients were assessed upon admission and again at discharge from the hospital.

Results: A poorer quality of sleep (higher PSQI scores) (Beta=0.590) was significantly associated with higher mania, whereas the intake of SSRIs (Beta=-5.952) and TCAs (Beta=-8.181) was significantly associated with lower mania. Furthermore, highly significant reductions were reported in the PSQI scores (4.96 vs. 2.75, P<0.001), ISI scores (8.30 vs. 3.45, P<0.001) and YMRS scores (8.60 vs. 3.06, P<0.001) between admission to and discharge from the hospital.

Conclusion: Insomnia in patients with bipolar disorder type I is associated with mania, with a significant reduction of sleep problems seen during a period of approximately 20 days of hospitalization. Further longitudinal studies are needed to confirm the validity of our results and identify the causes. In the meantime, this research recommends a strategy to improve sleeplessness experienced during inter-episode phases may be helpful in preventing manic episodes in BD.

Keywords: Bipolar disorder; Insomnia; Mania; Sleep.

MeSH terms

  • Bipolar Disorder* / complications
  • Bipolar Disorder* / drug therapy
  • Bipolar Disorder* / epidemiology
  • Hospitalization
  • Humans
  • Mania
  • Sleep Initiation and Maintenance Disorders* / complications
  • Sleep Initiation and Maintenance Disorders* / epidemiology