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. (April 2022)

• Record Type: Journal Article
• Authors: Scott, Jan; Etain, Bruno; Miklowitz, David; Crouse, Jacob J.; Carpenter, Joanne; Marwaha, Steven; Smith, Daniel; Merikangas, Kathleen; Hickie, Ian
• Is Part Of: Neuroscience and biobehavioral reviews. Volume 135(2022)
• Publication Date: 2022-04
• Subjects: Bipolar disorders -- Children -- Youth -- Circadian rhythms -- Sleep quality -- High risk -- First episode -- Meta-regression; ANX Anxiety disorder -- ADHD Attention deficit hyperactivity disorder -- ASx Asymptomatic -- BAR Bipolar-at-risk -- BD Bipolar disorders -- BD-I or II Bipolar disorder type I or type II -- BMI body mass index -- BLPD Borderline personality disorder -- CIs Confidence intervals -- DLMO Dim light melatonin onset -- EEG Electro-encephalogram -- EMA Ecological momentary assessment -- ESM Experience sampling method -- ES Effect size -- FT-BD Recent onset of Full-threshold BD episode(s) -- GBI General Behavioural Index -- HC Healthy controls -- HPS Hypomania Personality Scale -- HR High risk -- IS Interdaily stability -- ISRCTN International registry of clinical trials and studies (number) -- IV Intradaily variability -- LR Low risk -- MDD Major depressive disorder -- MDQ Mood Disorders Questionnaire -- MEQ Morningness Eveningness Questionnaire -- MOOSE Meta-analysis of observational studies in epidemiology -- MR Moderate risk -- N/C Number of studies/number of subgroup comparisons -- OR odds ratio -- OS Offspring -- OSBD Offspring of parents with BD -- OSBD (+ UP) Offspring of parents with bipolar and unipolar disorders -- OSC Offspring of controls -- OSCwD Offspring with depressive symptoms or syndromes -- OSUP Offspring of parents with unipolar disorders -- PE Parametric Effect -- PRISMA Preferred reporting for systematic reviews and meta-analyses -- PROSPERO Prospective register of systematic reviews -- PSQI Pittsburgh Sleep Quality Index -- PSG polysomnography -- PSYCH Psychotic disorder -- RA Relative amplitude -- s.e. standard error -- SE Sleep efficiency -- SRM Social Rhythm Metric -- SOff Sleep Offset -- SOn Sleep onset -- SOL Sleep onset latency -- SCRD Sleep and circadian rhythm disturbances -- TST Total sleep time -- WASO Awakenings after sleep onset; Psychophysiology -- Periodicals; Human behavior -- Periodicals; Animal behavior -- Periodicals; Neurology -- Periodicals; Behavior -- Periodicals; Ethology -- Periodicals; Neurology -- Periodicals; Psychophysiologie -- Périodiques; Comportement humain -- Périodiques; Animaux -- Mœurs et comportement -- Périodiques; Neurologie -- Périodiques; Animal behavior; Human behavior; Neurology; Psychophysiology; Periodicals; Electronic journals; 573.8
• DOI: 10.1016/j.neubiorev.2022.104585
• Languages: English
• ISSNs: 0149-7634

Abstract

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. Highlights: Sleep and circadian rhythm disturbances (SCRD) in young people at high risk of or with recent onset of bipolar disorders (BD) are poorly understood. We categorized early expression of BD into three groups: offspring of parents with BD (OSBD), Bipolar-at-Risk (BAR) individuals andcases with adolescent/early adulthood BD onset (FT-BD). A systematic search of the literature identified 76 relevant publications of which 35 provided data that could be included in random effects meta-analyses. BAR and FT-BD populations demonstrated eveningness chronotype and social and circadian dysrhythmias. Actigraphy studies demonstrated longer total sleep time especially in OSBD and FT-BD.