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Correlates of poor sleep based upon wrist actigraphy data in bipolar disorder

Authors
Kaufmann, Christopher N.Lee, Ellen E.Wing, DavidSutherland, Ashley N.Christensen, CelestineAncoli-Israel, SoniaDepp, Colin A.Yoon, Ho-KyoungSoontornniyomkij, BenchawannaEyler, Lisa T.
Issue Date
9월-2021
Publisher
PERGAMON-ELSEVIER SCIENCE LTD
Keywords
Actigraphy; Bipolar disorder; Data reduction; Sleep
Citation
JOURNAL OF PSYCHIATRIC RESEARCH, v.141, pp.385 - 389
Indexed
SCIE
SSCI
SCOPUS
Journal Title
JOURNAL OF PSYCHIATRIC RESEARCH
Volume
141
Start Page
385
End Page
389
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/136472
DOI
10.1016/j.jpsychires.2021.06.038
ISSN
0022-3956
Abstract
Background: Wrist-worn actigraphy can objectively measure sleep, and has advantages over self-report, particularly for people with Bipolar Disorder (BD) for whom self-reports might be influenced by affect. Clinically useful data reduction approaches are needed to explore these complex data. Methods: We created a composite score of sleep metrics in BD based on 51 BD and 80 healthy comparison (HC) participants. Subjects wore an actigraph for up to 14 consecutive 24-h periods, and we assessed total sleep time (TST), wake after sleep onset (WASO), percent sleep (PS), and number of awakenings (NA). We focused on participants who had at least 5 nights of actigraphy data. We computed z-scores for within-person means of sleep measures for BD subjects versus HCs, which were averaged to create a composite measure. We correlated this composite with participant characteristics, and used LASSO regression to identify sleep measures best explaining variability in identified correlates. Results: Sleep measures and the composite did not differ between BDs and HCs; however, there was considerable variability in z-scores among those with BD. In BDs, the composite score was higher in women (t(49) = 2.28, p = 0.027) and those who were employed (t(34) = 2.34, p = 0.025), and positively correlated with medication load (r = 0.41, p = 0.003) while negatively correlated with Young Mania Rating Scale (YMRS; r = -0.35, p = 0.030). In LASSO regression, TST and NA best explained medication load while PS best explained employment and YMRS. Conclusion: While a composite score of sleep metrics may provide useful information about sleep quality globally, our findings suggest that selection of theory-driven sleep measures may be more clinically meaningful.
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