OBJECTIVE: This study characterized objectively the hypersomnia
frequently seen in the depressed phase of bipolar affective disorder. On
the basis of previous work in sleep and affective disorders, it has been
hypothesized that the hypersomnia is related to greater REM sleep. This
hypothesis was tested by using a multiple sleep latency test to compare
bipolar affective disorder with narcolepsy, a well-defined primary sleep
disorder associated with known REM sleep dysfunction. METHOD: Twenty-five
bipolar depressed patients were selected on the basis of complaints of
hypersomnia. They underwent 2 nights of polysomnography followed by a
multiple sleep latency test. Data on their nocturnal sleep and daytime naps
were compared with similar data on 23 nondepressed narcoleptic patients
referred for sleep evaluation. RESULTS: Despite their complaints of
hypersomnia, no abnormalities were noted for the bipolar group in the
results from the multiple sleep latency test. Contrary to the working
hypothesis, REM sleep was notably absent during daytime naps in the
depressed patients, in marked contrast to the findings for the narcoleptic
group. CONCLUSIONS: The complaint of sleepiness in the hypersomnic bipolar
depressed patient appears to be related to the lack of interest,
withdrawal, decreased energy, or psychomotor retardation inherent in the
anergic depressed condition, rather than an increase in true sleep
propensity or REM sleep propensity.
Abstract Teaser