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Sleep and Activity Prodromes to Bipolar Disorder Symptomatic Episodes

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F68407700%3A21230%2F25%3A00388132" target="_blank" >RIV/68407700:21230/25:00388132 - isvavai.cz</a>

  • Result on the web

    <a href="https://doi.org/10.1111/bdi.70044" target="_blank" >https://doi.org/10.1111/bdi.70044</a>

  • DOI - Digital Object Identifier

Alternative languages

  • Result language

    angličtina

  • Original language name

    Sleep and Activity Prodromes to Bipolar Disorder Symptomatic Episodes

  • Original language description

    Introduction: Changes in activity and sleep often precede bipolar disorder (BD) episodes, but existing findings rely primarily on self-reports or objective activity and sleep measurements around self-reported episodes onsets. The duration of these prodromes varies widely across studies. We aim to determine prodrome duration objectively using long-term actigraphy and clinical assessments. Method: We collected longitudinal wrist-worn actigraphy and monthly clinician-rated scales (Montgomery-Åsberg Depression Rating Scale, MADRS and Young Mania Rating Scale, YMRS) from 229 BD patients, including 304 symptomatic episodes. Episodes were defined by scale thresholds [YMRS > 12 for (hypo)mania, MADRS >= 15 for depression] or hospitalisations. Deviations in sleep and physical activity (during the most active 10 h) from individual long-term averages were assessed up to 70 days before episodes. A closed-loop one-sided t-test (α = 0.05) determined significant prodrome duration, stopping at the first non-significant result. The 99% confidence intervals (CI) for the estimated average changes were calculated using data from the week before each episode to assess effect size. Results: Before manic episodes, sleep was reduced for 15-days (CI one week prior: 1.10–1.64 h), while activity increased for 14-days (CI: 31.5%–54.1% of the individuals' activity SD [IASD]). Before depressive episodes, no consecutive significant sleep changes were observed, but activity declined for 5-days (CI: 9.4%–25.6% of IASD). Conclusion: Our findings suggest that manic episodes have longer objectively measurable prodromes: reduced sleep and increased physical activity. In contrast, depressive episodes show no consistent sleep changes and a weaker and shorter decline in physical activity. These insights may support the development of focused early warning systems and targeted interventions.

  • Czech name

  • Czech description

Classification

  • Type

    O - Miscellaneous

  • CEP classification

  • OECD FORD branch

    20601 - Medical engineering

Result continuities

  • Project

    <a href="/en/project/EH22_008%2F0004643" target="_blank" >EH22_008/0004643: Brain dynamics</a><br>

  • Continuities

    P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Others

  • Publication year

    2025

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů