Assessment of sleep quality in bipolar euthymic patients

Objective: Sleep quality is affected in Bipolar Disorder (BPD) even in euthymic episodes. The aim of this study was to assess sleep quality in bipolar euthymic patients, determine clinical characteristics related with sleep quality and evaluate its effects on the course of disorder and functionality. Method: A total of 122 outpatients aged 18-65 who have been followed in Bipolar Disorder Unit of Department of Psychiatry, Cukurova University Medical School were included in the study. Hamilton Depression Rating Scale and Young Mania Rating Scale were used to confirm that patients were euthymic. A data form for socio-demographic features and another form for clinical characteristics of bipolar disorder have been completed. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-4) Axis I and Axis II were used to determine comorbidities. The general features of sleep were investigated by General Sleep Questionnaire. All patients completed Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Bipolar Disorder Functioning Questionnaire (BDFQ). Results: 56.5 % of our sample (mean age: 38,7±10,8 years) was found to have poor sleep quality. The majority of our sample were female (63,9 %), had mid or high level education (75,4 %) and socioeconomic status (75,4 %). Patients with poor sleep were found to have a longer time to fall asleep and more frequent waking after sleep onset. Caffeine use and smoking, history of suicide attempts, seasonality, using antidepressant medication and electroconvulsive therapy (ECT) were found to be higher and, emotional and intellectual functioning, household relations, taking initiative, self-sufficiency and total functionality as were measured by BDFQ were found to be lower in patients with poor sleep quality than patients with good sleep. All these results reach a statistically significant level (p<0,05). Conclusion: Sleep quality is affected negatively and is poor in euthymic episodes of BPD and poor sleep quality cause loss in functionality. It is concluded that assessment of sleep disturbances routinely in psychiatric interviews, dealing sleep disturbances regardless mood episodes and treating sleep disorders with psychosocial interventions or pharmacotherapy will improve sleep quality, functionality and quality of life mediately. Key Words: bipolar disorder, sleep quality, functionality