ABSTRACT
Introduction: Bipolar Affective Disorders is an episodic mooddisorder with significant global morbidity. Sleep deprivationin addition to being a core symptom and early warning sign ofimpending mood episodes can also trigger relapse. Individualswith Bipolar Affective Disorder in specific, differ in theirtendency for sleep loss to trigger relapse depending on theirsociodemographic and clinical factors.Current study objective was to evaluate the frequency andquality of sleep as a trigger for relapse of mood episode inpatients with bipolar affective disorders and to correlate itwith socio-demographic profile and clinical variables.Material and methods: This observational cross sectionalclinical study was conducted on 62 patients with ICD10diagnosis of bipolar affective disorders presenting with relapseof mood episode. Presence of acute sleep deprivation andchronic sleep insufficiency according to American academy ofsleep medicine criteria was considered. Young Mania RatingScale (YMRS) and Hamilton Depression Rating Scale (HAMD) were administered. Pittsburgh Sleep Quality Index (PSQI)Scale was used to assess quality of sleep. Written Informedconsents were taken from all the subjects. The data wasanalyzed with appropriate statistical methods.Results: Of the 62 patients assessed with diagnosis of bipolaraffective disorders presenting with mood episode, 58.1% havepoor quality of sleep and 41.9% have good quality of sleep.No statistically significant association noted in any domains ofsocio demographic profile. Statistically significant associationis noted with triggers in the present episode of relapse with94.4% of individual were noted to have sleep deprivation(p<0.001). 52.8% individuals with current episode manic,16.7% with depression, 27.8% with hypomania and 2.8% withcurrent episode mixed is noted to have poor quality of sleepand statistically significant association is noted with polarityof current episode. No statistically significant associationnoted between quality of sleep with other clinical variables.Conclusion:Poor quality of sleep may trigger relapse ofmood episode in patients with bipolar affective disorders.Our finding substantiates the need for careful assessment andmanagement of sleep disturbances during maintenance phasefor bipolar disorders