Features of dyssomnyas in primary episode of bipolar affective disorder
Bipolar affective disorder (BAD) is one of the actual problems in modern psychiatry. The aim of the study is to investigate dyssomnia in patients with primary episode of BAD, taking into account, the sex and clinical features of the diseases debut. We have clinically examined 65 men and 88 women diagnosed with bipolar affective disorder in the period 2015–2019. It was found that dyssomnia is present in 98.3% of all patients, in 97.7% of men and in 98.7% of women with depressive variant of the primary episode of BAD, accordingly in 30.4%, 26.7% and 37.5% of patients with manic variant and at 100,0% of patients with mixed variant. The structure of sleep disorders varies significantly depending on the variant of the primary episode: with depressive, prevail night and early awakenings (100.0%), sleep disturbance (75.6%, 70.5%, and 78.7%), unstable sleep (47.9%, 59.1% and 41.3%, p<0.05), nightmares (12.6%, 13.6% and 12.0%); at manic — unstable sleep (73.9%, 73.3% and 75.0%), sleep disturbance (17.4%, 13.3% and 25.0%) and frequent night awakenings (13.0%, 13.3% and 12.0%), in the mixed variant — falling asleep (72.7%, 66.7% and 80.0%), unstable sleep (72.7%, 83.3% and 60.0%), frequent night awakenings (54.5%, 66.7%, and 40.0%), early awakening (36.4%, 50.0%, and 20.0%) and nightmares (27.3%, 16.7% and 40.0%). Thus, the primary episode of bipolar affective disorder is accompanied by a wide range of dyssomnias, among which the leading are disorders of depth and stability of sleep. Manifestations of dyssomnia vary depending on the clinical type of the primary episode of BAD: with the depressive variant, prevail night awakenings, early awakenings and sleep disturbances, with unstable sleep, and with mixed sleep disturbance and unstable sleep. Dyssomnia prevalence is highest for mixed and lowest for manic variants. In depressive men, unstable sleep was more common, and the other disorders of sleep in men and women were not significantly different.
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