CNS spectrumsMay 6, 2024

Poor sleep quality and natural impulsive behavior in people with bipolar disorder

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 22, 2026

Abstract

Patients with bipolar disorder scored higher in impulsivity and sleep quality measures compared to healthy controls.

Bipolar disorder patients had elevated scores on the Barratt Impulsiveness Scale and Pittsburgh Sleep Quality Index compared to healthy individuals.
A positive correlation was found between total scores on the Pittsburgh Sleep Quality Index and the Barratt Impulsiveness Scale.
Sleep disturbance and daytime dysfunction were linked to higher attentional impulsiveness in bipolar disorder patients after adjusting for other factors.
Patients with high Pittsburgh Sleep Quality Index scores (>10) exhibited greater impulsivity across multiple dimensions compared to those with low scores (≤5).

Simplified

BACKGROUND: Sleep disturbance and impulsivity are key components of mood vulnerability in bipolar disorder (BD), but few studies have assessed the association between these two symptoms among patients with BD.

METHODS: Forty-seven euthymic patients with bipolar I disorder (BDI) or bipolar II disorder (BDII) and 58 age- and sex-matched healthy controls were enrolled in this cross-sectional study. Trait impulsivity was measured using the Barratt Impulsiveness Scale Version 11 (BIS-11), which yielded 3 second-order factors: attention, motor, and non-planning. Subjective sleep quality was assessed using the self-reported Pittsburgh Sleep Quality Index (PSQI). General linear models (GLMs) were used to assess the associations between subjective poor sleep and trait impulsivity with multiple testing corrections.

RESULTS: Patients with BD scored higher in BIS-11 and PSQI than healthy controls. PSQI total scores positively correlated with BIS-11 total scores, while sleep disturbance and daytime dysfunction were associated with attentional impulsiveness after controlling for covariates. Participants with higher PSQI total scores (>10) had higher scores in BIS-11 total, attention, and non-planning than those with low PSQI scores (≤5).

CONCLUSION: These findings support the hypothesis that poor sleep quality might lead to impulsivity and add to the growing evidence that improving sleep quality may be a therapeutic target for patients with BD.

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Poor sleep quality and natural impulsive behavior in people with bipolar disorder

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