Ambulatory sleep-wake patterns and variability in young people with emerging mental disorders

Sep 10, 2014Journal of psychiatry & neuroscience : JPN

Daily sleep and wake patterns and their changes in young people starting to develop mental health problems

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Abstract

A total of 342 participants aged 12-35 years were enrolled, revealing significant sleep-wake cycle differences among young individuals with mental disorders.

Sleep onset occurred later in the anxiety, depression, and bipolar disorder groups compared to healthy controls.
All primary diagnosis groups experienced a later sleep offset than the control group.
The sleep period was longer for individuals with anxiety, bipolar disorder, and psychosis.
Total sleep time was extended in the psychosis group.
Sleep efficiency was lower in the depression group, with similar trends in the anxiety and bipolar groups.
Sleep parameters exhibited significantly more variability in patient subgroups than in controls.

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BACKGROUND: The nature of sleep-wake abnormalities in individuals with mental disorders remains unclear. The present study aimed to examine the differences in objective ambulatory measures of the sleep-wake and activity cycles across young people with anxiety, mood or psychotic disorders.

METHODS: Participants underwent several days of actigraphy monitoring. We divided participants into 5 groups (control, anxiety disorder, unipolar depression, bipolar disorder, psychotic disorder) according to primary diagnosis.

RESULTS: We enrolled 342 participants aged 12-35 years in our study: 41 healthy controls, 56 with anxiety disorder, 135 with unipolar depression, 80 with bipolar disorder and 30 with psychotic disorders. Compared with the control group, sleep onset tended to occur later in the anxiety, depression and bipolar groups; sleep offset occurred later in all primary diagnosis groups; the sleep period was longer in the anxiety, bipolar and psychosis groups; total sleep time was longer in the psychosis group; and sleep efficiency was lower in the depression group, with a similar tendency for the anxiety and bipolar groups. Sleep parameters were significantly more variable in patient subgroups than in controls. Cosinor analysis revealed delayed circadian activity profiles in the anxiety and bipolar groups and abnormal circadian curve in the psychosis group.

LIMITATIONS: Although statistical analyses controlled for age, the sample included individuals from preadolescence to adulthood. Most participants from the primary diagnosis subgroups were taking psychotropic medications, and a large proportion had other comorbid mental disorders.

CONCLUSION: Our findings suggest that delayed and disorganized sleep offset times are common in young patients with various mental disorders. However, other sleep-wake cycle disturbances appear to be more prominent in broad diagnostic categories.

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Ambulatory sleep-wake patterns and variability in young people with emerging mental disorders

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