Study of the different sleep disturbances during the prodromal phase of depression and mania in bipolar disorders

Louise Basquin; Julia Maruani; Jeanne Leseur; Sibylle Mauries; Balthazar Bazin; Guillaume Pineau; Chantal Henry; Michel Lejoyeux; Pierre A. Geoffroy

doi:10.1111/bdi.13429

journal article Open Access Apr 23, 2024

Study of the different sleep disturbances during the prodromal phase of depression and mania in bipolar disorders

Louise Basquin

Julia Maruani Jeanne Leseur

Sibylle Mauries Balthazar Bazin Guillaume Pineau Chantal Henry Michel Lejoyeux Pierre A. Geoffroy

Bipolar Disorders Vol. 26 No. 5 pp. 454-467 · Wiley

View at Publisher Save 10.1111/bdi.13429

Abstract

AbstractBackgroundOne of the challenges in bipolar disorder (BD) lies in early detection of the illness and its recurrences, to improve prognosis. Sleep disturbances (SD) have been proposed as reliable predictive markers of conversion. While preliminary studies have explored the relationship between SD and the onset of mood episodes, the results remain heterogeneous and a few have specifically examined patients' perception of prodromal symptoms and their progression until the episode occurs. Identifying prodromes represents a crucial clinical challenge, as it enables early intervention, thereby reducing the severity of BD. Therefore, the objective of this study is to better characterize and evaluate the progressive nature of SD as prodromal symptoms of mood episodes, and patients' perception of it.MethodsPatients diagnosed with BD, either hospitalized or seeking treatment for a (hypo)manic or depressive episode benefited from standardized questionnaires, structured interviews, and self‐report questionnaires to evaluate SD prior to the current episode, as well as sociodemographic and clinical information.ResultsOut of the 41 patients included, 59% spontaneously reported SD prior to the episode, appearing 90 days before depression and 35 days before mania (pre‐indexed/spontaneous reports: 51.22% insomnia complaints, 4.88% hypersomnolence complaints, 7.32% parasomnias, 2.44% sleep movements). After inquiry about specific SD, the percentage of patients reporting prodromal SD increased significantly to 83%, appearing 210 days before depression and 112.5 days before mania (post‐indexed reports: 75.61% presented with insomnia complaints appearing 150 days before depression and 20 days before mania, 46.34% had hypersomnolence complaints appearing 60 days before depression, 43.9% had parasomnias appearing 210 days before depression and 22.5 days before mania, 36.59% had sleep movements appearing 120 days before depression and 150 days before mania). Of note, bruxism appeared in 35% of patients before mania, and restless legs syndrome in 20% of patients before depression.ConclusionThis study highlights the very high prevalence of SD prior to a mood episode in patients with BD with differences between depressive and manic episodes. The more systematic screening of sleep alterations of the prodromal phase improved the recognition and characterization of different symptoms onset by patients. This underscores the need for precise questioning regarding sleep patterns in patients, to better identify the moment of transition toward a mood episode, referred to as "Chronos syndrome". The study emphasizes the importance of educating patients about the disorder and its sleep prodromal symptoms to facilitate early intervention and prevent recurrences.

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Details

Published: Apr 23, 2024
Vol/Issue: 26(5)
Pages: 454-467
License: View

Authors

L

Louise Basquin

Département de Psychiatrie et d'addictologie AP‐HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat ‐ Claude Bernard Paris France; NeuroDiderot, Inserm, FHU I2‐D2 Université Paris Cité Paris France

J

Julia Maruani

Département de Psychiatrie et d'addictologie AP‐HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat ‐ Claude Bernard Paris France; NeuroDiderot, Inserm, FHU I2‐D2 Université Paris Cité Paris France; GHU Paris ‐ Psychiatrie & Neurosciences Paris France

J

Jeanne Leseur

Département de Psychiatrie et d'addictologie AP‐HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat ‐ Claude Bernard Paris France

S

Sibylle Mauries

Département de Psychiatrie et d'addictologie AP‐HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat ‐ Claude Bernard Paris France; NeuroDiderot, Inserm, FHU I2‐D2 Université Paris Cité Paris France; GHU Paris ‐ Psychiatrie & Neurosciences Paris France

B

Balthazar Bazin

GHU Paris ‐ Psychiatrie & Neurosciences Paris France

G

Guillaume Pineau

Département de Psychiatrie et d'addictologie AP‐HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat ‐ Claude Bernard Paris France

C

Chantal Henry

GHU Paris ‐ Psychiatrie & Neurosciences Paris France; Department of Psychiatry Service Hospitalo‐Universitaire, GHU Paris Psychiatrie & Neurosciences Paris France; Université de Paris Paris France

M

Michel Lejoyeux

Département de Psychiatrie et d'addictologie AP‐HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat ‐ Claude Bernard Paris France; NeuroDiderot, Inserm, FHU I2‐D2 Université Paris Cité Paris France; GHU Paris ‐ Psychiatrie & Neurosciences Paris France

P

Pierre A. Geoffroy

Département de Psychiatrie et d'addictologie AP‐HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat ‐ Claude Bernard Paris France; NeuroDiderot, Inserm, FHU I2‐D2 Université Paris Cité Paris France; GHU Paris ‐ Psychiatrie & Neurosciences Paris France; CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences Strasbourg France

Cite This Article

Louise Basquin, Julia Maruani, Jeanne Leseur, et al. (2024). Study of the different sleep disturbances during the prodromal phase of depression and mania in bipolar disorders. Bipolar Disorders, 26(5), 454-467. https://doi.org/10.1111/bdi.13429

Study of the different sleep disturbances during the prodromal phase of depression and mania in bipolar disorders

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