Sleep quality, chronotype and metabolic syndrome components in bipolar disorders during the remission period: Results from the FACE-BD cohort

ABSTRACT

Data on sleep or circadian abnormalities and metabolic disturbances in euthymic bipolar disorders are scarce and based on small sample sizes. The aim of this study was to explore the associations between sleep disturbances, chronotype and metabolic components in a large sample of euthymic patients with bipolar disorders (BD). From 2009 to 2015, 752 individuals with bipolar disorders from the FACE-BD cohort were included and assessed for sleep quality, chronotype and metabolic components. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) was used to confirm the diagnosis of BD. Subjective sleep quality was measured with the Pittsburgh Sleep Quality Index and chronotype with the Composite Scale of Morningness. Sociodemographic and clinical characteristics, psychotropic treatment, psychiatric comorbidities and blood samples were collected. In our sample, 22.4% of individuals with BD presented with a metabolic syndrome, 53.7% had sleep disturbances, 25.4% were considered as having an evening chronotype and 12.6% as having a morning chronotype. Independently of potential confounders, euthymic patients with sleep disturbances had a higher abdominal circumference, and patients with evening chronotype had a significantly higher level of triglycerides. There was an association between evening chronotype and an increased atherogenic index of plasma (OR = 4.8, 95%CI = 1.6–14.7). Our findings contribute the scant literature on the relationship between sleep quality, chronotype and cardiometabolic components in euthymic individuals with BD and highlight the need to improve quality of sleep and patient education about healthier sleep-hygiene practices.

Keywords:

• Bipolar disorders
• chronotype
• metabolic syndrome
• risk factors
• sleep disorders

Acknowledgments

We thank the FondaMental Foundation (www-fondation-fondamental.org) for scientific cooperation in mental health, which is developing a new model for translational research in psychiatry in France and supports the infrastructure of Bipolar Expert Centers. We express our thanks to the nurses, and to the patients who were included in the present study. We thank Hakim Laouamri, and his team (Stéphane Beaufort, Seif Ben Salem, Karmène Souyris,Victor Barteau and Mohamed Laaidi) for the development of the FACE-BP computer interface, data management, quality control and regulatory aspects. The authors thank FondaMental Advanced Centers of Expertise for Bipolar Disorders (FACE BD) collaborators:

FACE-BD Clinical Coordinating Center (FondaMental Foundation):

C. Henry, B. Etain, M. Leboyer

FACE-BD Data Coordinating Center (FondaMental Foundation):

H. Laouamri, K. Souryis, V. Barteau, O. Godin

FACE-BD Clinical Sites and Principal Collaborators in France

Center in Creteil: A. Raust

Center in Paris: S. Sportiche, P.A. Geoffroy, S. Yeim

Center in Bordeaux: B. Aouizerate, A. Desage, K. M’Bailara

Center in Montpellier: E. Olie, D. Ducasse, F. Moliere

Center in Marseille: R. Belzeaux, N. Viglianaise, L. Lescalier

Center in Nancy: M. Perrin-Payet, R. Cohen, O. Wajsbrot-Elgrabli, R. Guillot

Center in Grenoble: M. Polosan, S. Garcon

Center in Versailles: M.C. Hardy-Bayle, N. Kayser, I. Grevin

Center in Monaco: J. Loftus, L. Albertini, I. Medecin, I. Cussac

Declaration of interest

The Author(s) declare(s) that there is no conflict of interest.

Additional information

Funding

This research was supported by the Foundation FondaMental, Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP, and by the Investissements d’Avenir program managed by the ANR under reference ANR-11-IDEX-0004-02 and ANR-10-COHO-10-01. This funding source had no role in the study design, data collection, analysis, preparation of the manuscript, or decision to submit the manuscript for publication. All authors have approved the manuscript.