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The relationship between sleep and depression and bipolar disorder in children and young people

Lookup NU author(s): Dr Monica Comsa, Dr Kirstie Anderson, Dr Aditya SharmaORCiD, Dr Stuart Watson



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Copyright © The Author(s), 2022. Background Sleep difficulties are often reported in practice, and are part of the diagnostic criteria for depression and bipolar disorder. Aims To inform the understanding of the relationship between sleep and both depression and bipolar disorder. Method We conducted a narrative literature review of affective disorders and sleep difficulties in children and young people. Results Specific sleep disorders, such as parasomnias, narcolepsy and sleep-related movement disorders, are associated with depression, whereas insomnia, obstructive sleep apnoea and circadian rhythm disorders are associated with both depression and bipolar disorder in children and young people. Conversely, children and young people with depression can present with a number of sleep difficulties, and these are associated with higher depression severity and greater fatigue, suicidal ideation, physical complaints, pain and decreased concentration. Sleep disturbances among adolescents with bipolar disorder can affect the severity of depressive and manic symptoms, are a poor prognostic indicator and have been associated with social and academic impairment. Antidepressants and antipsychotics can directly affect sleep architecture, which clinicians need to be aware of. Non-pharmacological interventions for sleep problems could prevent and/or minimise the risk of relapse in affective disorders. Conclusions Sleep difficulties can occur before, during and after an episode of depression or bipolar disorder, and have a higher prevalence in affective disorders compared with the general population. A multi-modal approach would include the treatment of both the affective and specific sleep disorder. Further research is needed in this field to understand the impact of combined interventions on clinical outcomes.

Publication metadata

Author(s): Comsa M, Anderson KN, Sharma A, Yadav VC, Watson S

Publication type: Review

Publication status: Published

Journal: BJPsych Open

Year: 2022

Volume: 8

Issue: 1

Online publication date: 14/01/2022

Acceptance date: 03/12/2021

ISSN (electronic): 2056-4724

Publisher: Cambridge University Press


DOI: 10.1192/bjo.2021.1076