Sleep disturbance and mood disturbance are intertwined in bipolar disorder (BD), and sleep quality differs in men and women.
In this study, we aimed to determine whether perception of poor sleep quality would have a different effect on mood outcome in men versus women. In 216 individuals with BD in the Prechter Longitudinal Study of Bipolar Disorder, we assessed association between sleep quality at study intake and the severity, variability, and frequency of manic and depressive episodes over two years. We found that poor sleep quality at the start of the study predicted worse depression and more frequent depression for women, but not for men. Additionally, poor sleep quality predicted worse severity and variability of mania.
These associations between sleep quality and poor mood outcome in women were present even when other factors were accounted for, including age, baseline mood severity, neuroticism, and stress. We conclude that in this longitudinal study of BD, women reported poorer perceived sleep quality than men, and poor sleep quality predicted worse mood outcome in women with BD.
Clinicians should be sensitive to addressing sleep complaints in women with BD early in treatment to improve outcome in BD.