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A systematic review and meta-analysis of sleep and circadian rhythms disturbances in individuals at high-risk of developing or with early onset of bipolar disorders - PubMed

Jan Scott  1 ,

Meta-Analysis

A systematic review and meta-analysis of sleep and circadian rhythms disturbances in individuals at high-risk of developing or with early onset of bipolar disorders

Jan Scott et al. Neurosci Biobehav Rev. 2022 Apr.

Abstract

Sleep and circadian rhythms disturbances (SCRD) in young people at high risk or with early onset of bipolar disorders (BD) are poorly understood. We systematically searched for studies of self, observer or objective estimates of SCRD in asymptomatic or symptomatic offspring of parents with BD (OSBD), individuals with presentations meeting recognised BD-at-risk criteria (BAR) and youth with recent onset of full-threshold BD (FT-BD). Of 76 studies eligible for systematic review, 35 (46%) were included in random effects meta-analyses. Pooled analyses of self-ratings related to circadian rhythms demonstrated greater preference for eveningness and more dysregulation of social rhythms in BAR and FT-BD groups; analyses of actigraphy provided some support for these findings. Meta-analysis of prospective studies showed that pre-existing SCRD were associated with a 40% increased risk of onset of BD, but heterogeneity in assessments was a significant concern. Overall, we identified longer total sleep time (Hedges g: 0.34; 95% confidence intervals:.1, .57), especially in OSBD and FT-BD and meta-regression analysis indicated the effect sizes was moderated by the proportion of any sample manifesting psychopathology or receiving psychotropic medications. This evolving field of research would benefit from greater attention to circadian rhythm as well as sleep quality measures.

Keywords: Bipolar disorders; Children; Circadian rhythms; First episode; High risk; Meta-regression; Sleep quality; Youth.

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Conflict of interest statement

Conflicts of Interest-

Professors Scott, Etain, Miklowitz, Smith and Marwaha, plus Drs Crouse and Carpenter declare no conflicts in respect to the submitted manuscript.

Figures

Figure 1:

Pooled analyses of actigraphy metrics in OSBD or BAR groups versus comparators (see text for details) a) Eligible OSBD studies b) Eligible BAR studies *Citations for studies included in pooled analyses are provided in the main text. S/C: Numbers of Studies/Comparisons included in pooled analysis; OS: Offspring; BAR: Bipolar at Risk; BD: Bipolar Disorders; HC: Healthy Controls; RA: Relative Amplitude; IS: Interdaily stability; IV: Intradaily variability; SE: Sleep efficiency; SOL: Sleep onset latency; SOn: Sleep onset; SOff: Sleep offset; TST: Total sleep time

Figure 2:

Pooled analyses of actigraphy metrics in OSBD or BAR groups versus comparators (see text for details) *Citations for studies included in pooled analyses are provided in the main text. S/C: Numbers of Studies/Comparisons included in pooled analysis; BD: Bipolar Disorders; HC: Healthy Controls; SE: Sleep efficiency; SOL: Sleep onset latency; SOn: Sleep onset; SOff: Sleep offset; TST: Total sleep time; WASO: Awakening after sleep onset.

Figure 3:

Pooled analyses of studies of Total Sleep Time (TST) categorized according to comparisons with Healthy Controls (individuals with minimal or no symptoms) or individuals with psychiatric symptoms or disorders (non-HC) ADHD: Attention deficit hyperactivity disorder; ANX: Anxiety disorder; BAR: Bipolar at risk group; BD: Bipolar disorder; BLPD: Borderline personality disorder; FT: Full-threshold; HC: Healthy controls; LR: Low Risk (as assessed with BAR instrument); OSBD: Offspring of parent with Bipolar Disorder; OSC: Offspring of healthy controls; OSCwD: OSC who have depression; OSUP: Offspring of parents with UP; PSYCH: psychosis ;UP: Unipolar depression.

References

    1. *Alloy LB, Boland EM, Ng TH, Whitehouse WG, Abramson LY. 2015. Low social rhythm regularity predicts first onset of bipolar spectrum disorders among at-risk individuals with reward hypersensitivity. J Abnorm Psychol. Nov;124(4):944–952. doi: 10.1037/abn0000107. - DOI - PMC - PubMed
    1. Alvaro P, Roberts R, Harris J. 2013. A Systematic review assessing bidirectionality between sleep disturbances, anxiety, and depression. Sleep. Jul 1;36(7):1059e68. - PMC - PubMed
    1. *Ankers D, Jones SH. 2009. Objective assessment of circadian activity and sleep patterns in individuals at behavioural risk of hypomania. J Clin Psychol. Oct;65(10):1071–86. doi: 10.1002/jclp.20608. - DOI - PubMed
    1. Baddam SKR, Canapari CA, van Noordt SJR, Crowley MJ. 2018. Sleep disturbances in child and adolescent mental health disorders: A review of the variability of objective sleep markers. Med Sci (Basel). Jun 4;6(2):46. doi: 10.3390/medsci6020046. - DOI - PMC - PubMed
    1. Barton J, Kyle SD, Varese F, Jones SH, Haddock G. 2018. Are sleep disturbances causally linked to the presence and severity of psychotic-like, dissociative and hypomanic experiences in non-clinical populations? A systematic review. Neurosci Biobehav Rev. Jun;89:119–131. doi: 10.1016/j.neubiorev.2018.02.008. - DOI - PubMed