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Links between sleep and body mass index in bipolar disorders: An exploratory study

Published online by Cambridge University Press:  15 April 2020

C. Boudebesse*
Inserm, U955, Créteil, France AP–HP, Hôpital H.-Mondor–A.-Chenevier, Pôle de Psychiatrie, DHU PePSY, Créteil, France Fondation Fondamental, Créteil, France
P.-A. Geoffroy
Inserm, U955, Créteil, France Fondation Fondamental, Créteil, France Pôle de Psychiatrie, Université Lille Nord de France, CHRU de Lille, Lille, France
C. Henry
Inserm, U955, Créteil, France Université Paris Est, Faculté de Médecine, Créteil, France AP–HP, Hôpital H.-Mondor–A.-Chenevier, Pôle de Psychiatrie, DHU PePSY, Créteil, France Fondation Fondamental, Créteil, France
A. Germain
Department of Psychiatry, University of Pittsburgh School of Medicine, PittsburghPA 15213, USA
J. Scott
Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK Centre for Affective Disorders, Institute of Psychiatry, London, UK
M. Lajnef
Inserm, U955, Créteil, France
M. Leboyer
Inserm, U955, Créteil, France Université Paris Est, Faculté de Médecine, Créteil, France AP–HP, Hôpital H.-Mondor–A.-Chenevier, Pôle de Psychiatrie, DHU PePSY, Créteil, France Fondation Fondamental, Créteil, France
F. Bellivier
Fondation Fondamental, Créteil, France AP–HP, GH Saint-Louis–Lariboisière–Fernand-Widal, Pôle Neurosciences, Paris, France Université Paris-7 Paris-Diderot, UFR de Médecine, Paris, France
B. Etain
Inserm, U955, Créteil, France AP–HP, Hôpital H.-Mondor–A.-Chenevier, Pôle de Psychiatrie, DHU PePSY, Créteil, France Fondation Fondamental, Créteil, France
Corresponding author. Pôle de Psychiatrie des Hôpitaux Universitaires Henri-Mondor, Centre Expert Bipolaire, pavillon Hartmann, Hôpital Albert-Chenevier, 40, rue de Mesly, 94000 Créteil cedex, France. Tel.: +33 1 49 81 32 90; fax: +33 1 49 81 30 99. E-mail address: (C. Boudebesse).
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Study objectives:

Obesity and excess bodyweight are highly prevalent in individuals with bipolar disorders (BD) and are associated with adverse consequences. Multiple factors may explain increased bodyweight in BD including side effects of psychotropic medications, and reduced physical activity. Research in the general population demonstrates that sleep disturbances may also contribute to metabolic burden. We present a cross-sectional study of the associations between body mass index (BMI) and sleep parameters in patients with BD as compared with healthy controls (HC).


Twenty-six French outpatients with remitted BD and 29 HC with a similar BMI completed a 21-day study of sleep parameters using objective (actigraphy) and subjective (PSQI: Pittsburgh Sleep Quality Index) assessments.


In BD cases, but not in HC, higher BMI was significantly correlated with lower sleep efficiency (P = 0.009) and with several other sleep parameters: shorter total sleep time (P = 0.01), longer sleep onset latency (P = 0.05), higher fragmentation index (P = 0.008), higher inter-day variability (P = 0.05) and higher PSQI total score (P = 0.004).


The findings suggest a link between a high BMI and several sleep disturbances in BD, including lower sleep efficiency. Physiological mechanisms in BD cases may include an exaggeration of phenomena observed in non-clinical populations. However, larger scale studies are required to clarify the links between metabolic and sleep-wake cycle disturbances in BD.

Original article
Copyright © European Psychiatric Association 2020

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Institution at which the work was performed: AP–HP, Hôpital H.-Mondor–A.-Chenevier, Pôle de Psychiatrie, Créteil, France.


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