Variability in Sleep Is Associated with Trait-Based and Daily Measures of Bipolar Spectrum Psychopathology

ABSTRACT

Introduction

Although sleep disturbances are well documented in bipolar spectrum disorders (BSDs), significantly less research has examined whether these disturbances are present in those at risk for developing BSDs or with subsyndromal symptoms. The present study examined associations between risk for BSDs, as measured by the Hypomanic Personality Scale (HPS), and sleep assessed using experience sampling. We assessed whether intraindividual variability in sleep was associated with affect, cognition, and behavior in daily life and potential directionality of these relationships.

Methods

233 young adults oversampled for high scores on the HPS completed 14 days of experience sampling assessing total sleep time (TST), bed/rise time, sleep quality, affect (negative and positive affect), cognition (difficulty concentrating, racing thoughts), and behavior (impulsivity) in daily life. We used Dynamic Structural Equation Modeling (DSEM) to assess within-person links between sleep and bipolar spectrum psychopathology.

Results

HPS scores were associated with less TST, later bedtime, and more variable TST and bedtime. Variability in TST was associated with negative affect, difficulty concentrating/racing thoughts, and impulsivity. Within-person decreases in sleep were associated with next day increases in negative affect, stress, difficulty concentrating, and racing thoughts.

Limitations

Measurement of sleep was limited. Future studies should examine both objective measures of sleep (e.g., actigraphy) and fragmentation in sleep.

Conclusions

Risk for BSD was associated with similar patterns of sleep disruptions as seen in BSDs. Important dynamic links between sleep and bipolar spectrum psychopathology emerged indicating that sleep is an important target for improving symptoms of BSDs in daily life.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Notes

¹ Note that this measure of TST does not account for wake after sleep onset (WASO) as participants were not asked about their nighttime awakenings. However, it is calculated based on the time the participant fell asleep and woke up, not the times they got into bed or got out of bed.

² Sleep surveys were automatically set to be available each morning. One participant completed an extra sleep survey the day after the ESM study was completed.

Additional information

Funding

This work received no funding support, and the authors have no disclosures to report.