부산대학교 도서관

Background: Sleep problems often increase the recurrence of mood dysregulation and relapse among patients with bipolar disorder. Continually monitoring sleep quality may predict mood symptoms for the provision of early intervention. However, the dynamic relationship between sleep quality and mood symptoms remains unclear. Purpose: This study examined the associations between subjective and objective sleep quality and mood symptom severity among patients with bipolar disorder. Methods: This longitudinal study with a convenience sample of 104 inpatients with bipolar disorder was conducted in a medical center in southern Taiwan. Their subjective and objective sleep quality and mood symptom severity were assessed at the first appointment, 1 month after the first appointment, and 3 months after the first appointment. Their demographics were collected, and wearable devices were used to monitor sleep quality; the Pittsburgh Sleep Quality Index; the Young Mania Rating Scale; Hamilton Depression Rating Scale; Self-reported Depression, Anxiety, and Stress Scales; and the Altman Mania Scale were all used to assess patients. Results: The means of subjective and objective sleeping hours at the 3 time points ranged from 7 to 8 hours. Most patients reported poor sleep quality with mild depression and a remission of manic symptoms. Sleep quality total scores at the 3 time points were weakly and moderately correlated with subjective and objective anxiety, stress, and mood symptoms. Subjective sleep quality (P = 0.009), stress symptoms (P = 0.012), and subjective and objective manic symptoms (P ＜ 0.001) changed over time. After a month, subjective sleep hours and subjective anxiety symptoms (b = .834, p = .022), stress symptoms (b = .082, p = .007) and depression symptoms (b = .931, p = .003) were significantly correlated, showing that sleep hours increased with symptomatic improvement. Additionally, subjective sleeping hours were associated with patients' perceived anxiety (b = 0.246, P ＜ 0.001), stress (b = 0.236, P ＜ 0.001), and both subjective and patients' perceived depression symptoms (b = 0.220, P = 0.001; b = 0.179, P = 0.005, respectively). Conclusions: The sleep quality of patients with bipolar disorder is highly correlated with their mood symptoms. Dynamic associations across 1 month of subjective sleeping hours and sleep quality with their subjective anxiety and depression symptoms were observed. Maintaining a self-monitor diary or using wearable devices to record patients' sleep changes are suggested to stabilize the mood symptoms and prevent relapse.