A Test of the Bidirectional Relationship between Sleep and Mood in Bipolar Disorder and Insomnia

The present study investigates sleep, mood, and the proposed bidirectional relationship between the two in psychiatric disorders. Participants with interepisode bipolar disorder (n = 49), insomnia (n = 34), and no psychiatric history (n = 52) completed seven days of sleep diaries and mood measures. The interepisode bipolar and insomnia participants exhibited greater sleep disturbance than the healthy control individuals. Negative mood was equally heightened in both interepisode bipolar disorder and insomnia. Total wake time was associated with next day morning mood disturbance in bipolar disorder while pre-sleep mood disturbance was associated with subsequent total wake time in both bipolar disorder and insomnia. Total sleep time and mood disturbance were not significantly associated in either diagnostic group. Results support the theory that disruptions in nighttime sleep and daytime mood may be mutually maintaining and suggest the potential importance of transdiagnostic or universal processes