Sylvia LG et al. – This study investigated the influence of poor baseline sleep on outcomes in bipolar patients treated with quetiapine and lithium. The authors concluded that baseline sleep disturbance was associated with severe bipolar symptoms and poor prognosis at 6 months. The authors also suggest exploring the role of psychosocial interventions in improving sleep disorder in bipolar patients.

Methods

• Patients with bipolar disorder (n = 482) were randomized to receive quetiapine or lithium.
• The patients received adjunctive personalized treatments in accordance with guidelines or empirically based medications as needed.
• Statistical models were used to find the impact of sleep disturbance on treatment outcomes.

Results

• Sleep disturbance was identified in 63% of patients. The severity of bipolar illness, depression, mania, anxiety, irritability, and psychosis was worse in these patients. The patients reported significantly less sustained response (P = .0006) and greater clinical adjustments (P = .03).