Exploratory Study on the Associations between Lifetime Post-Traumatic Stress Spectrum, Sleep, and Circadian Rhythm Parameters in Patients with Bipolar Disorder

Claudia Carmassi, Francy Cruz-Sanabria (), Davide Gravina, Miriam Violi, Chiara Bonelli, Valerio Dell’Oste, Virginia Pedrinelli, Paolo Frumento, Ugo Faraguna and Liliana Dell’Osso
Additional contact information
Claudia Carmassi: Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
Francy Cruz-Sanabria: Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56126 Pisa, Italy
Davide Gravina: Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
Miriam Violi: Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
Chiara Bonelli: Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
Valerio Dell’Oste: Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
Virginia Pedrinelli: Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
Paolo Frumento: Department of Political Sciences, University of Pisa, 56126 Pisa, Italy
Ugo Faraguna: Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56126 Pisa, Italy
Liliana Dell’Osso: Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy

IJERPH, 2023, vol. 20, issue 4, 1-16

Abstract: The present study aimed at exploring whether lifetime post-traumatic stress spectrum symptoms are associated with chronotype in patients with bipolar disorder (BD). Moreover, we explored whether the chronotype can moderate the potential associations between lifetime post-traumatic stress spectrum symptoms and rest–activity circadian and sleep-related parameters. A total of 74 BD patients were administered the Trauma and Loss Spectrum Self-Report (TALS-SR) lifetime version for lifetime post-traumatic stress spectrum symptoms, the Pittsburgh Sleep Quality Index (PSQI) for self-reported sleep quality, and the Reduced Morningness–Eveningness Questionnaire (rMEQ) to discriminate evening chronotypes (ETs), neither chronotype (NT), and morning chronotype (MT). Actigraphic monitoring was used to objectively evaluate sleep and circadian parameters. Patients classified as ET reported significantly higher scores in the re-experiencing domain, as well as poorer sleep quality, lower sleep efficiency, increased wake after sleep onset, and delayed mid-sleep point compared with both NT and MT ( p -value ≤ 0.05). Moreover, ET presented significantly higher scores in the TALS-SR maladaptive coping domain than NT and lower relative amplitude than MT ( p -value ≤ 0.05). Moreover, higher TALS-SR total symptomatic domains scores were significantly correlated with poor self-reported sleep quality. Regression analyses showed that the PSQI score maintained the association with the TALS total symptomatic domains scores after adjusting for potentially confounding factors (age and sex) and that no interaction effect was observed between the chronotype and the PSQI. Conclusions: This exploratory study suggests that patients with BD classified as ET showed significantly higher lifetime post-traumatic stress spectrum symptoms and more disrupted sleep and circadian rhythmicity with respect to other chronotypes. Moreover, poorer self-reported sleep quality was significantly associated with lifetime post-traumatic stress spectrum symptoms. Further studies are required to confirm our results and to evaluate whether targeting sleep disturbances and eveningness can mitigate post-traumatic stress symptoms in BD.

Keywords: chronotype; bipolar disorder; post-traumatic stress symptoms; rest–activity; sleep; actigraphy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/20/4/3566/pdf (application/pdf)
https://www.mdpi.com/1660-4601/20/4/3566/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:20:y:2023:i:4:p:3566-:d:1071684

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().