Sleep problems common in children with bipolar disorder
MedWire News: Most children with bipolar disorder experience sleep problems during mood episodes, US study results show.
Writing in Frontiers in Child and Neurodevelopmental Psychiatry, Argelinda Baroni (New York University) and team explain that "although there are published reports on sleep in adults with bipolar disorder, data on the characteristics of sleep disturbances in children with bipolar disorder and their frequency is still minimal."
The researchers therefore studied 70 children (42 boys), aged an average of 10.8 years (range 5-17 years), with bipolar disorder who attended a specialty outpatient clinic in New York. Of these, 24 were diagnosed with bipolar I disorder (BD I) and 46 with bipolar disorder not otherwise specified (BD NOS), as assessed using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version (K-SADS-PL).
There were no significant differences between BD I and BD-NOS groups regarding age, gender, ethnicity, and socioeconomic status.
The K-SADS-PL mood and voiding disorders modules were used to assess the children for sleep variables during mood episodes, including decreased need for sleep, repeated nighttime voiding (nocturnal enuresis), insomnia, and circadian reversal.
The researchers found that sleep problems were very common among the children, with 84.3% experiencing at least one sleep symptom during a mood episode.
The most common sleep symptom during mood episodes was insomnia (71.4%), which mainly occurred during depressive episodes, followed by decreased need for sleep (51.4%), which occurred during episodes of mania. Other common sleep symptoms included nocturnal enuresis (27.1%) and circadian reversal (22.9%).
There were no significant differences in the frequency or type of sleep symptoms between children with BD I and those with BD-NOS after accounting for medication status, the researchers note.
Among children with BD I, those with a decreased need for sleep showed significantly worse functioning than those without, and a similar, but nonsignificant, trend was observed in children with BD-NOS.
Baroni and team conclude: "Sleep disturbances appear to be a frequent and important feature of BD early in the course of the illness.
"Recognizing their prevalence may lead to earlier and more aggressive treatment, possibly improving future course of the illness, socio-emotional development, and academic functioning, in the same way sleep hygiene positively affects the course of bipolar disorder in adults."
By Mark Cowen