SYSTEMATIC REVIEW AND META-ANALYSIS ON THE RELATIONSHIP BETWEEN SLEEP PATTERNS AND COGNITIVE FUNCTIONS IN BIPOLAR DISORDER PATIENTS
Main Article Content
Keywords
bipolar disorder, sleep disturbance, sleep efficiency, REM sleep, cognitive function, memory, executive function, attention
Abstract
Background: Bipolar disorder (BD) is a significant psychiatric condition, affecting millions globally, characterized by alternating periods of mania and depression. Cognitive impairments, often associated with mood disturbances, are increasingly being linked to sleep disturbances in both BD Type I and BD Type II patients. These impairments encompass a wide range of cognitive domains, including memory, executive functioning, and attention. The intricate relationship between sleep and cognitive function in BD patients is crucial for optimizing treatment outcomes.
Objective: This systematic review and meta-analysis aim to evaluate the relationship between specific sleep patterns (e.g., sleep efficiency, latency, REM/NREM stages) and cognitive performance in BD patients, with a focus on differentiating between BD Type I and II. Furthermore, the study seeks to explore how these sleep-cognitive interactions may be moderated by demographic factors and comorbid conditions.
Methodology: A comprehensive search of five databases was conducted, and 25 studies meeting strict inclusion criteria were selected for analysis. The analysis included observational studies and randomized controlled trials. A meta-analysis was performed, focusing on the correlation between sleep disturbances and cognitive outcomes across different cognitive domains and BD subtypes.
Results: Results showed that sleep disturbances were more severe in patients with BD Type I than those with BD Type II, and these impairments emerged as significant predictors of cognitive dysfunction. Sleep efficiency, latency, and REM sleep were also strong predictors of cognitive performance and together accounted for 35% of the variance in cognitive outcomes.
Conclusion: Contrary to early findings, evidence from recent studies supports the response that sleep management should be included in treatment protocols for BD patients to improve cognitive outcomes. Second, BD subtype-specific interventions that target sleep disturbances may also alleviate cognitive impairments, and enhance the life quality of these patients.
Objective: This systematic review and meta-analysis aim to evaluate the relationship between specific sleep patterns (e.g., sleep efficiency, latency, REM/NREM stages) and cognitive performance in BD patients, with a focus on differentiating between BD Type I and II. Furthermore, the study seeks to explore how these sleep-cognitive interactions may be moderated by demographic factors and comorbid conditions.
Methodology: A comprehensive search of five databases was conducted, and 25 studies meeting strict inclusion criteria were selected for analysis. The analysis included observational studies and randomized controlled trials. A meta-analysis was performed, focusing on the correlation between sleep disturbances and cognitive outcomes across different cognitive domains and BD subtypes.
Results: Results showed that sleep disturbances were more severe in patients with BD Type I than those with BD Type II, and these impairments emerged as significant predictors of cognitive dysfunction. Sleep efficiency, latency, and REM sleep were also strong predictors of cognitive performance and together accounted for 35% of the variance in cognitive outcomes.
Conclusion: Contrary to early findings, evidence from recent studies supports the response that sleep management should be included in treatment protocols for BD patients to improve cognitive outcomes. Second, BD subtype-specific interventions that target sleep disturbances may also alleviate cognitive impairments, and enhance the life quality of these patients.
References
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4. Bradley, A. J., Anderson, K. N., Gallagher, P., & McAllister-Williams, R. H. (2020). The association between sleep and cognitive abnormalities in bipolar disorder. Psychological Medicine, 50(1), 125-132. https://doi.org/10.1017/S0033291718004038
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7. Kaufmann, C. N., Gershon, A., Eyler, L. T., & Depp, C. A. (2016). Clinical significance of mobile health assessed sleep duration and variability in bipolar disorder. Journal of Psychiatric Research, 81, 152-159. https://doi.org/10.1016/j.jpsychires.2016.07.008
8. Morton, E., & Murray, G. (2020). Assessment and treatment of sleep problems in bipolar disorder—a guide for psychologists. Clinical Psychology & Psychotherapy, 27(3), 364-377. https://doi.org/10.1002/cpp.2433
9. Pearson, O., Uglik-Marucha, N., Miskowiak, K. W., Cairney, S. A., Rosenzweig, I., Young, A. H., & Stokes, P. R. (2023). The relationship between sleep disturbance and cognitive impairment in mood disorders: A systematic review. Journal of Affective Disorders, 327, 207-216. https://doi.org/10.1016/j.jad.2023.01.114
10. Russo, M., Mahon, K., Shanahan, M., Ramjas, E., Solon, C., Purcell, S. M., & Burdick, K. E. (2015). The relationship between sleep quality and neurocognition in bipolar disorder. Journal of Affective Disorders, 187, 156-162. https://doi.org/10.1016/j.jad.2015.08.009
11. Shamsaei, F., Yadollahifar, S., & Sadeghi, A. (2020). Relationship between sleep quality and quality of life in patients with bipolar disorder. Sleep Science, 13(1), 65-69. https://doi.org/10.5935/1984-0063.20190135
12. Saunders, E. F. H., Novick, D. M., Fernandez-Mendoza, J., Kamali, M., Ryan, K. A., Langenecker, S. A., Gelenberg, A. J., & McInnis, M. G. (2013). Sleep quality during euthymia in bipolar disorder: The role of clinical features, personality traits, and stressful life events. International Journal of Bipolar Disorders, 1(16). https://doi.org/10.1186/2194-7511-1-16
13. Naga Rajitha, N., Vainala, A., Saritha, G., & Hariprasad, A. (2024). Assessing the relationship between sleep patterns and cognitive functions in patients with bipolar disorder. International Journal of Academic Medicine and Pharmacy, 6(2), 643-647.
2. Boland, E. M., & Alloy, L. B. (2013). Sleep disturbance and cognitive deficits in bipolar disorder: Toward an integrated examination of disorder maintenance and functional impairment. Clinical Psychology Review, 33(1), 33-44. https://doi.org/10.1016/j.cpr.2012.10.001
3. Boland, E. M., Stange, J. P., Molz, A. M., Adams, A., LaBelle, D. R., & Ong, M. L. (2015). Associations between sleep disturbance, cognitive functioning, and work disability in bipolar disorder. Psychiatry Research, 230(2), 567-574. https://doi.org/10.1016/j.psychres.2015.09.051
4. Bradley, A. J., Anderson, K. N., Gallagher, P., & McAllister-Williams, R. H. (2020). The association between sleep and cognitive abnormalities in bipolar disorder. Psychological Medicine, 50(1), 125-132. https://doi.org/10.1017/S0033291718004038
5. Chauhan, S., Kumari, V., Pandey, R., Vakani, K., Norbury, R., & Ettinger, U. (2024). Sleep quality mediates the association between chronotype and mental health in young Indian adults. npj Mental Health Research. https://doi.org/10.1038/s44184-024-00076-9
6. Harvey, A. G., Talbot, L. S., & Gershon, A. (2009). Sleep disturbance in bipolar disorder across the lifespan. Clinical Psychology: Science and Practice, 16(2), 256-277. https://doi.org/10.1111/j.1468-2850.2009.01164.x
7. Kaufmann, C. N., Gershon, A., Eyler, L. T., & Depp, C. A. (2016). Clinical significance of mobile health assessed sleep duration and variability in bipolar disorder. Journal of Psychiatric Research, 81, 152-159. https://doi.org/10.1016/j.jpsychires.2016.07.008
8. Morton, E., & Murray, G. (2020). Assessment and treatment of sleep problems in bipolar disorder—a guide for psychologists. Clinical Psychology & Psychotherapy, 27(3), 364-377. https://doi.org/10.1002/cpp.2433
9. Pearson, O., Uglik-Marucha, N., Miskowiak, K. W., Cairney, S. A., Rosenzweig, I., Young, A. H., & Stokes, P. R. (2023). The relationship between sleep disturbance and cognitive impairment in mood disorders: A systematic review. Journal of Affective Disorders, 327, 207-216. https://doi.org/10.1016/j.jad.2023.01.114
10. Russo, M., Mahon, K., Shanahan, M., Ramjas, E., Solon, C., Purcell, S. M., & Burdick, K. E. (2015). The relationship between sleep quality and neurocognition in bipolar disorder. Journal of Affective Disorders, 187, 156-162. https://doi.org/10.1016/j.jad.2015.08.009
11. Shamsaei, F., Yadollahifar, S., & Sadeghi, A. (2020). Relationship between sleep quality and quality of life in patients with bipolar disorder. Sleep Science, 13(1), 65-69. https://doi.org/10.5935/1984-0063.20190135
12. Saunders, E. F. H., Novick, D. M., Fernandez-Mendoza, J., Kamali, M., Ryan, K. A., Langenecker, S. A., Gelenberg, A. J., & McInnis, M. G. (2013). Sleep quality during euthymia in bipolar disorder: The role of clinical features, personality traits, and stressful life events. International Journal of Bipolar Disorders, 1(16). https://doi.org/10.1186/2194-7511-1-16
13. Naga Rajitha, N., Vainala, A., Saritha, G., & Hariprasad, A. (2024). Assessing the relationship between sleep patterns and cognitive functions in patients with bipolar disorder. International Journal of Academic Medicine and Pharmacy, 6(2), 643-647.
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Published
Oct 24, 2024
Article Details
How to Cite
Dr Alya Abdallah Youssef Al Hamadi, Dr Hafsah Abdirahiim Maalim, Dr Ashtar Kariem, Dr Meera Al Shamsi, Dr Latifa Al Abdal, Dr Noora Alomaira, Dr Hussain Aljabal, Dr. Fathima Farzana, Ramla Mehak Khan, Dr Aethar Faraj, & Dr Fathima Aaliya Anwar. (2024). SYSTEMATIC REVIEW AND META-ANALYSIS ON THE RELATIONSHIP BETWEEN SLEEP PATTERNS AND COGNITIVE FUNCTIONS IN BIPOLAR DISORDER PATIENTS. Journal of Population Therapeutics and Clinical Pharmacology, 31(10), 493-501. https://doi.org/10.53555/5v9zah12
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Author Biographies
Dr Alya Abdallah Youssef Al Hamadi
Medicilinic Hospital
Dr Hafsah Abdirahiim Maalim
Omdurman Islamic University.
Dr Ashtar Kariem
Trainee Physician, SGH, Dubai, UAE.
Dr Meera Al Shamsi
Zayed Higher Organization for People of Determination.
Dr Latifa Al Abdal
Intern at EHS RAK hospitals.
Dr Noora Alomaira
Sheikh Khalifa Medical City (SKMC)
Dr Hussain Aljabal
University Hospital of North Tees.
Dr. Fathima Farzana
General Practitioner, GSM Medical Center LLC.
Ramla Mehak Khan
Shifa College of Medicine.
Dr Aethar Faraj
Dubai Medical College Graduate.
Dr Fathima Aaliya Anwar
Graduated from Rak Medical Health Sciences University.
How to Cite
Dr Alya Abdallah Youssef Al Hamadi, Dr Hafsah Abdirahiim Maalim, Dr Ashtar Kariem, Dr Meera Al Shamsi, Dr Latifa Al Abdal, Dr Noora Alomaira, Dr Hussain Aljabal, Dr. Fathima Farzana, Ramla Mehak Khan, Dr Aethar Faraj, & Dr Fathima Aaliya Anwar. (2024). SYSTEMATIC REVIEW AND META-ANALYSIS ON THE RELATIONSHIP BETWEEN SLEEP PATTERNS AND COGNITIVE FUNCTIONS IN BIPOLAR DISORDER PATIENTS. Journal of Population Therapeutics and Clinical Pharmacology, 31(10), 493-501. https://doi.org/10.53555/5v9zah12