Characterization and factors associated with sleep quality in adolescents with bipolar I disorder

Child Psychiatry Hum Dev. 2011 Dec;42(6):724-40. doi: 10.1007/s10578-011-0239-0.


Sleep disturbance is an early marker for bipolar disorder (BD) onset in youth. We characterized sleep quality in adolescents experiencing mania within the last 6-12 months. We examined the association between mood and sleep in 27 adolescents with BD and 24 matched healthy controls (HC). Subjects were assessed by parent and teen report of sleep, a semi-structured clinical interview, the Young Mania Rating Scale (YMRS), and the Childhood Depression Rating Scale (CDRS-R). Average BD youth YMRS (mean 20.3 ± 7.3) and CDRS-R (mean 42.4 ± 14.1) scores indicated they were still ill at time of assessment. Compared to HCs, adolescents with BD have distinct patterns of prolonged sleep onset latency, frequent nighttime awakenings, and increased total time awake. Mood symptoms, specifically excessive guilt, self-injurious behavior, and worsening evening mood, interfered with sleep. Further studies are needed to determine whether early regulation of sleep would improve long-term outcome in BD youth.

MeSH terms

  • Adolescent
  • Affect / drug effects*
  • Bipolar Disorder* / complications
  • Bipolar Disorder* / diagnosis
  • Bipolar Disorder* / drug therapy
  • Bipolar Disorder* / psychology
  • Female
  • Humans
  • Interview, Psychological
  • Male
  • Psychiatric Status Rating Scales
  • Psychotropic Drugs / therapeutic use
  • Risk Factors
  • Self Report
  • Self-Injurious Behavior* / etiology
  • Self-Injurious Behavior* / prevention & control
  • Self-Injurious Behavior* / psychology
  • Sleep / drug effects*
  • Sleep Wake Disorders* / diagnosis
  • Sleep Wake Disorders* / drug therapy
  • Sleep Wake Disorders* / etiology
  • Sleep Wake Disorders* / psychology


  • Psychotropic Drugs