ORIGINAL ARTICLE Sleep in bipolar patients Larriany M. F. Giglio & Ana C. Andreazza & Mônica Andersen & Keila M. Ceresér & Julio C. Walz & Laura Sterz & Flávio Kapczinski Received: 16 April 2008 / Revised: 28 July 2008 / Accepted: 4 August 2008 / Published online: 4 November 2008 # Springer-Verlag 2008 Abstract Background Sleep disturbance has been described in bipolar disorder (BPD). Specific complaints may include frequent nighttime awakenings, poor quality of sleep, reduction in total sleep time, and nightmares. Most patients with BPD also report insomnia when in depression, but a significant percentage of patients report hypersomnia symptoms with prolonged nighttime sleep, difficulty in wakening, and excessive daytime sleepiness. Objectives The present study aims to investigate whether bipolar patients with sleep disorders presented impairment in quality of life, disability, and global function. Methods One hundred ninety bipolar patients type-I diag- nosed by application of Structured Clinician Interview for DSM-IV Disorders (SCID), were distributed in two groups based on absence or presence of sleep disorders. Quality of life, disability, and global dysfunction were evaluated using the Health Organization’ s Quality of Life instrument (WHOQOL-Brief), the Sheehan Disability Scale, and the Global Assessment of Functioning (GAF), respectively. Results Sleep complaints have negative influence on general quality of life, observed by decreased scores in WHOQOL and GAF domains and increased Sheehan scores, indicating the importance of maintenance of normal sleep in bipolar patients. Conclusion Our results suggest that sleep complains impair quality of life and global function. Collectively, further studies are warranted to investigate the impairment of sleep disturbance on others neurotrophic factors and neurochem- ical pathways. Keywords Bipolar disorder . Sleep . Quality of life . Insomnia . Disability . GAF Introduction Sleep is an active state, critical for our physical, mental and emotional well-being and is favorable for brain plasticity [1–3]. Several studies showed that sleep periods encompass processes ranging from reactivation of neuronal ensembles during post-training sleep to molecular changes [1, 4]. Further, sleep is important for optimal cognitive and overall functioning [5]. However, sleep disorders are very common in the general population, affecting 10–20% of adults [6, 7] with an impact in daytime functioning [8]. Sleep disorder coexists with a number of physical and psychiatric conditions, including psychoses, anxiety disor- ders, and mood disorders [5–7]. The sleep–wake cycle has been a core component of theoretical conceptualizations of bipolar disorder (BPD) and circadian rhythm instability is a frequent complaint in these patients [9]. Insomnia, as well as hypersomnia, with prolonged nighttime sleep, difficulty in awakening, and excessive daytime sleepiness is often experienced by depressive bipolar patients [10]. Longitudi- Sleep Breath (2009) 13:169–173 DOI 10.1007/s11325-008-0215-5 L. M. F. Giglio (*) : A. C. Andreazza : K. M. Ceresér : J. C. Walz : L. Sterz : F. Kapczinski Bipolar Disorders Program-Centro de Pesquisas, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, 90035-003 Porto Alegre, RS, Brazil e-mail: larriany@terra.com.br A. C. Andreazza : J. C. Walz : L. Sterz Department of Biochemistry, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil M. Andersen : J. C. Walz : L. Sterz Department of Psichobiology, UNIFESP, Universidade Federal de São Paulo, São Paulo, SP, Brazil