SLEEP 2011 Abstract Supplement

B. Clinical Sleep Science IX. Psychiatric and Behavioral Disorders and Sleep
0713
INSOMNIA SYMPTOMS AND CARDIOVASCULAR RISK
AMONG RESPONDENTS WITH BIPOLAR DISORDER IN
THE NATIONAL COMORBIDITY SURVEY-REPLICATION
Soehner A, Harvey AG
Psychology, University of California, Berkeley, Berkeley, CA, USA
Introduction: In the past decade, there has been increasing concern
about the elevated prevalence of cardiovascular risk factors in bipolar
disorder. Parallel to these findings, epidemiologic evidence suggests that
insomnia symptoms (e.g. difficulty falling or staying asleep, or waking
up too early) are independently associated with higher rates of cardiovascular
risk factors in the general population. Given that sleep is pervasively
disturbed in bipolar populations, the aim of the study was to
examine the association between insomnia symptoms and cardiovascular
risk factors in patients with bipolar disorder in the National Comorbidity
Survey - Replication (NCS-R).
Methods: The NCS-R is a nationally representative survey of the U.S.
population (ages 18+) conducted between 2001 and 2003. From this
sample, 176 respondents with a lifetime bipolar disorder diagnosis were
identified for the present study. The prevalence of self-reported cardiovascular
risk factors (obesity, hypertension, and diabetes/high blood
sugar) was compared across three subgroups of respondents with bipolar
diagnoses, based on the presence of (a) chronic insomnia symptoms,
(b) acute insomnia symptoms, or (c) no sleep problems in the past year.
Prevalence estimates, as well as odds ratios adjusted for demographic
and clinical variables (AORs) in logistic regression analyses, were corrected
for the complex survey design.
Results: Rates of obesity and hypertension were statistically greater in
bipolar patients with chronic (41.8%; 28.8%) and acute (43.7%; 24.1%)
insomnia symptoms compared to bipolar patients with good sleep
(19.7%; 5.9%). Diabetes/high blood sugar prevalence did not significantly
differ between groups. Insomnia symptom duration remained a
significant predictor of obesity (AOR=1.5) and hypertension (AOR=2.2)
after controlling for clinical and demographic factors.
Conclusion: Insomnia symptoms, particularly those that are chronic in
nature, may confer risk for obesity and hypertension in bipolar disorder.
Thus, sleep disturbance may represent one pathway contributing to the
high rates of CVD observed in bipolar disorder.
Support (If Any): R34MH080958
0714
DIURNAL VARIATION IN RELATIVE BRAIN GLUCOSE
METABOLISM WITHIN THE REWARD CIRCUIT IN ADULTS
WITH PRIMARY INSOMNIA
Hasler BP 1 , Nofzinger E 1 , Germain A 1 , James JA 2 , Buysse DJ 1
1
Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh,
PA, USA, 2 Radiology, University of Pittsburgh, Pittsburgh, PA, USA
Introduction: Converging evidence indicates that reward motivation
shows circadian modulation. Self-reported positive affect, as well as
reward-related behaviors and physiology, show circadian rhythms, with
lowest levels in the morning and peaks in the evening. These rhythms
may be particularly salient for insomnia patients, who have altered diurnal
variation in mood and arousal. However, no prior studies have
examined the neural underpinnings of circadian-reward interactions in
insomnia patients. The aim of these analyses was to characterize diurnal
variation in relative brain glucose metabolism of regions within the reward
circuit in adults with insomnia.
Methods: [18F]-fluorodeoxyglucose positron emission tomography
scans were conducted during quiet wakefulness in the morning and evening
in 23 adults with primary insomnia. Statistical parametric mapping
was used to compare relative glucose metabolism during the two scans.
Region-of-interest (ROI) analyses focused on reward-related regions,
including the medial prefrontal cortex (mPFC) and striatum (caudate,
putamen, and nucleus accumbens), using a threshold of p