Sleep and Cardiovascular Dysfunctions in Bipolar Disorder

American Psychiatric Association, DSMTF, Diagnostic and statistical manual of mental disorders: DSM-5. Fifth edition. ed. DSM-5. Arlington: American Psychiatric Association; 2013. Lopez AD, Murray CJ, WH Organization. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Harvard School of Public Health; 1996. http://apps.who.int/iris/bitstream/10665/41864/1/0965546608_eng.pdf. Accessed 25 July 2017. Roshanaei-Moghaddam B, Katon W. Premature mortality from general medical illnesses among persons with bipolar disorder: a review. Psychiatr Serv. 2009;60(2):147–56. Murray D, et al. Mania and mortality: why the excess cardiovascular risk in bipolar disorder? Curr Psychiatry Rep. 2009;11(6):475–80. Prieto M, et al. Risk of myocardial infarction and stroke in bipolar disorder: a systematic review and exploratory meta-analysis. Acta Psychiatr Scand. 2014;130(5):342–53. Crump C, et al. Comorbidities and mortality in bipolar disorder: a Swedish national cohort study. JAMA Psychiatry. 2013;70(9):931–9. Goldstein BI, et al. Inflammation and the phenomenology, pathophysiology, comorbidity, and treatment of bipolar disorder: a systematic review of the literature. J Clin Psychiatry. 2009;70(8):1078–90. Hamdani N, Tamouza R, Leboyer M. Immuno-inflammatory markers of bipolar disorder: a review of evidence. Front Biosci (Elite edition). 2011;4:2170–82. Brietzke E, et al. Comparison of cytokine levels in depressed, manic and euthymic patients with bipolar disorder. J Affect Disord. 2009;116(3):214–7. Dickerson F, et al. Elevated serum levels of C-reactive protein are associated with mania symptoms in outpatients with bipolar disorder. Prog Neuro-Psychopharmacol Biol Psychiatry. 2007;31(4):952–5. Dargél AA, et al. C-reactive protein alterations in bipolar disorder: a meta-analysis. J Clin Psychiatry. 2015;76(2):142–50. Munkholm K, et al. Elevated levels of IL-6 and IL-18 in manic and hypomanic states in rapid cycling bipolar disorder patients. Brain Behav Immun. 2015;43:205–13. Becking K, et al. The association between immune activation and manic symptoms in patients with a depressive disorder. Transl Psychiatry. 2013;3(10):e314. Bengesser S, et al. Peripheral markers of oxidative stress and antioxidative defense in euthymia of bipolar disorder—gender and obesity effects. J Affect Disord. 2015;172:367–74. Leboyer M, et al. Can bipolar disorder be viewed as a multi-system inflammatory disease? J Affect Disord. 2012;141(1):1–10. Madamanchi NR, Vendrov A, Runge MS. Oxidative stress and vascular disease. Arterioscler Thromb Vasc Biol. 2005;25(1):29–38. Hopps E, et al. A novel component of the metabolic syndrome: the oxidative stress. Nutr Metab Cardiovasc Dis. 2010;20(1):72–7. Schnabel R, Blankenberg S. Oxidative stress in cardiovascular disease successful translation from bench to bedside? Circulation. 2007;116(12):1338–40. Hatch J, et al. Cardiovascular and psychiatric characteristics associated with oxidative stress markers among adolescents with bipolar disorder. J Psychosom Res. 2015;79(3):222–7. Weiner M, Warren L, Fiedorowicz JG. Cardiovascular morbidity and mortality in bipolar disorder. Ann Clin Psychiatry. 2011;23(1):40. Goldstein BI, et al. Cardiovascular disease and hypertension among adults with bipolar I disorder in the United States. Bipolar Disord. 2009;11(6):657–62. • Vancampfort, D, et al. Metabolic syndrome and metabolic abnormalities in bipolar disorder: a meta-analysis of prevalence rates and moderators. Am J Psychiatry. 2013;170(3):265–74. This meta-analysis suggests that individuals with bipolar disorder are at elevated risk for metabolic syndrome, as well as related cardiovascular mortality and morbidity. Silarova B, et al. Metabolic syndrome in patients with bipolar disorder: comparison with major depressive disorder and non-psychiatric controls. J Psychosom Res. 2015;78(4):391–8. Chien I-C, et al. Risk of hypertension in patients with bipolar disorder in Taiwan: a population-based study. Compr Psychiatry. 2013;54(6):687–93. Hsu J-H, Chien I-C, Lin C-H. Increased risk of hyperlipidemia in patients with bipolar disorder: a population-based study. Gen Hosp Psychiatry. 2015;37(4):294–8. Van Winkel R, et al. Prevalence of diabetes and the metabolic syndrome in a sample of patients with bipolar disorder. Bipolar Disord. 2008;10(2):342–8. Shah A, Shen N, El-Mallakh RS. Weight gain occurs after onset of bipolar illness in overweight bipolar patients. Ann Clin Psychiatry. 2006;18(4):239–41. Vancampfort D, et al. The metabolic syndrome is associated with self-reported physical complaints in patients with bipolar disorder. Psychiatr Danub. 2016;28(2):139–45. Moon E, et al. Comparative study of heart rate variability in patients with schizophrenia, bipolar disorder, post-traumatic stress disorder, or major depressive disorder. Clin Psychopharmacol Neurosci. 2013;11(3):137. Henry BL, et al. Heart rate variability in bipolar mania and schizophrenia. J Psychiatr Res. 2010;44(3):168–76. Lee JS, et al. Heart rate variability in the subsyndromal depressive phase of bipolar disorder. Psychiatry Clin Neurosci. 2012;66(4):361–6. Prieto ML, et al. Association between history of psychosis and cardiovascular disease in bipolar disorder. Bipolar Disord. 2015;17(5):518–27. Rousseau G, Bah TM, Godbout R. Post-myocardial infarction depression. In: Lakshmanadoss U, editor. Novel strategies in ischemic heart disease. Croatia: InTech; 2012. p. 333–62. Santos CO, et al. Mania and stroke: a systematic review. Cerebrovasc Dis. 2011;32(1):11–21. Fenn D, George K. Post-stroke mania late in life involving the left hemisphere. Aust N Z J Psychiatry. 1999;33(4):598–600. Nagaratnam N, Wong K-K, Patel I. Secondary mania of vascular origin in elderly patients: a report of two clinical cases. Arch Gerontol Geriatr. 2006;43(2):223–32. Ruzickova M, et al. Clinical features of bipolar disorder with and without comorbid diabetes mellitus. Can J Psychiatry. 2003;48(7):458–61. Colton CW, Manderscheid RW. Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Prev Chronic Dis. 2006;3(2):A42. Calkin C, et al. Can body mass index help predict outcome in patients with bipolar disorder? Bipolar Disord. 2009;11(6):650–6. Le Grande MR, et al. Relationship between sleep disturbance, depression and anxiety in the 12 months following a cardiac event. Psychol Health Med. 2016;21(1):52–9. Hayano J, et al. Interactive associations of depression and sleep apnea with adverse clinical outcomes after acute myocardial infarction. Psychosom Med. 2012;74(8):832. Angst F, et al. Mortality of patients with mood disorders: follow-up over 34–38 years. J Affect Disord. 2002;68(2):167–81. Tsai S-Y, et al. A retrospective analysis of risk and protective factors for natural death in bipolar disorder. J Clin Psychiatry. 2005;66(12):1586–91. Williams MD, et al. Direct costs of bipolar disorder versus other chronic conditions: an employer-based health plan analysis. Psychiatr Serv. 2015;62(9):1073–78. Merikangas KR, et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry. 2007;64(5):543–52. Pettersen H, et al. Walking the fine line: self-reported reasons for substance use in persons with severe mental illness. Int J Qual Stud Health Well-Being. 2013;8:21968. Gilman SE, Dupuy JM, Perlis RH. Risks for the transition from major depressive disorder to bipolar disorder in the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2012;73(6):829–36. Martins SS, et al. Mood and anxiety disorders and their association with non-medical prescription opioid use and prescription opioid-use disorder: longitudinal evidence from the National Epidemiologic Study on Alcohol and Related Conditions. Psychol Med. 2012;42(6):1261–72. Schepis TS, Hakes JK. Non-medical prescription use increases the risk for the onset and recurrence of psychopathology: results from the National Epidemiological Survey on Alcohol and Related Conditions. Addiction. 2011;106(12):2146–55. Schepis TS, Hakes JK. Dose-related effects for the precipitation of psychopathology by opioid or tranquilizer/sedative nonmedical prescription use: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Addict Med. 2013;7(1):39–44. •• Ritter PS, et al. Disturbed sleep as risk factor for the subsequent onset of bipolar disorder—data from a 10-year prospective-longitudinal study among adolescents and young adults. J Psychiatr Res. 2015;68:76–82. This 10-year prospective-longitudinal study based on a large sample shows that insomnia symptoms at baseline significantly increase the risk of developing bipolar disorder. Proudfoot J, et al. Triggers of mania and depression in young adults with bipolar disorder. J Affect Disord. 2012;143(1–3):196–202. Putnins SI, et al. Poor sleep at baseline predicts worse mood outcomes in patients with co-occurring bipolar disorder and substance dependence. J Clin Psychiatry. 2012;73(5):703–8. Jerrell JM, McIntyre RS, Tripathi A. A cohort study of the prevalence and impact of comorbid medical conditions in pediatric bipolar disorder. J Clin Psychiatry. 2010;71(11):1518–25. Sylvia LG, et al. Medical burden in bipolar disorder: findings from the Clinical and Health Outcomes Initiative in Comparative Effectiveness for Bipolar Disorder study (Bipolar CHOICE). Bipolar Disord. 2015;17(2):212–23. Araos P, et al. Plasma profile of pro-inflammatory cytokines and chemokines in cocaine users under outpatient treatment: influence of cocaine symptom severity and psychiatric co-morbidity. Addict Biol. 2015;20(4):756–72. Mata MM, et al. Methamphetamine decreases CD4 T cell frequency and alters pro-inflammatory cytokine production in a model of drug abuse. Eur J Pharmacol. 2015;752:26–33. Prossin AR, et al. Dynamic interactions between plasma IL-1 family cytokines and central endogenous opioid neurotransmitter function in humans. Neuropsychopharmacology. 2015;40(3):554–65. de Zambotti M, et al. Cardiac autonomic function during sleep: effects of alcohol dependence and evidence of partial recovery with abstinence. Alcohol. 2015;49(4):409–15. de Zambotti M, et al. Poor autonomic nervous system functioning during sleep in recently detoxified alcohol-dependent men and women. Alcohol Clin Exp Res. 2014;38(5):1373–80. Roerecke M, Rehm J. The cardioprotective association of average alcohol consumption and ischaemic heart disease: a systematic review and meta-analysis. Addiction. 2012;107(7):1246–60. Fernandez-Sola J. Cardiovascular risks and benefits of moderate and heavy alcohol consumption. Nat Rev Cardiol. 2015;12(10):576–87. Quintana DS, et al. A meta-analysis on the impact of alcohol dependence on short-term resting-state heart rate variability: implications for cardiovascular risk. Alcohol Clin Exp Res. 2013;37(Suppl 1):E23–9. Desbois AC, Cacoub P. Cannabis-associated arterial disease. Ann Vasc Surg. 2013;27(7):996–1005. Hackam DG. Cannabis and stroke: systematic appraisal of case reports. Stroke. 2015;46(3):852–6. Jouanjus E, et al. Cannabis use: signal of increasing risk of serious cardiovascular disorders. J Am Heart Assoc. 2014;3(2):e000638. Thomas G, Kloner RA, Rezkalla S. Adverse cardiovascular, cerebrovascular, and peripheral vascular effects of marijuana inhalation: what cardiologists need to know. Am J Cardiol. 2014;113(1):187–90. Cerretani D, et al. Role of oxidative stress in cocaine-induced cardiotoxicity and cocaine-related death. Curr Med Chem. 2012;19(33):5619–23. Liaudet L, Calderari B, Pacher P. Pathophysiological mechanisms of catecholamine and cocaine-mediated cardiotoxicity. Heart Fail Rev. 2014;19(6):815–24. Phillips K, et al. Cocaine cardiotoxicity: a review of the pathophysiology, pathology, and treatment options. Am J Cardiovasc Drugs. 2009;9(3):177–96. Henry BL, Minassian A, Perry W. Effect of methamphetamine dependence on heart rate variability. Addict Biol. 2012;17(3):648–58. Won S, et al. Methamphetamine-associated cardiomyopathy. Clin Cardiol. 2013;36(12):737–42. Degenhardt L, et al. Causes of death in a cohort treated for opioid dependence between 1985 and 2005. Addiction. 2014;109(1):90–9. Garcia AN, Salloum IM. Polysomnographic sleep disturbances in nicotine, caffeine, alcohol, cocaine, opioid, and cannabis use: a focused review. Am J Addict. 2015;24(7):590–8. Angarita GA, et al. Sleep abnormalities associated with alcohol, cannabis, cocaine, and opiate use: a comprehensive review. Addict Sci Clin Pract. 2016;11(1):9. Chitty KM, et al. A longitudinal proton magnetic resonance spectroscopy study investigating oxidative stress as a result of alcohol and tobacco use in youth with bipolar disorder. J Affect Disord. 2015;175:481–7. Etain B, et al. Beyond genetics: childhood affective trauma in bipolar disorder. Bipolar Disord. 2008;10(8):867–76. Belvederi Murri M, et al. The HPA axis in bipolar disorder: systematic review and meta-analysis. Psychoneuroendocrinology. 2016;63:327–42. Program, BCDS. Acute adverse reactions to prednisone in relation to dosage. Clin Pharmacol Ther. 1972;13(5):694–8. Lewis DA, Smith RE. Steroid-induced psychiatric syndromes: a report of 14 cases and a review of the literature. J Affect Disord. 1983;5(4):319–32. Lewis L, Cochrane G. Psychosis in a child inhaling budesonide. Lancet. 1983;322(8350):634. Brown ES, et al. Mood changes during prednisone bursts in outpatients with asthma. J Clin Psychopharmacol. 2002;22(1):55–61. Türktaş I, Gücüyener K, Özden A. Medication-induced psychotic reaction. J Am Acad Child Adolesc Psychiatry. 1997;36(8):1017–8. Wolkowitz OM, et al. Prednisone effects on neurochemistry and behavior: preliminary findings. Arch Gen Psychiatry. 1990;47(10):963–8. Deak T, et al. Neuroimmune mechanisms of stress: sex differences, developmental plasticity, and implications for pharmacotherapy of stress-related disease. Stress. 2015;18(4):367–80. Gold PW, Machado-Vieira R, Pavlatou MG. Clinical and biochemical manifestations of depression: relation to the neurobiology of stress. Neural Plast. 2015;2015:581976. Tian R, et al. A possible change process of inflammatory cytokines in the prolonged chronic stress and its ultimate implications for health. ScientificWorldJournal. 2014;2014:780616. Juster RP, McEwen BS, Lupien SJ. Allostatic load biomarkers of chronic stress and impact on health and cognition. Neurosci Biobehav Rev. 2010;35(1):2–16. Massar SA, Liu JC, Chee MW. Habitual poor sleep efficiency is associated with increased cardiovascular and cortisol response to psychological stress. J Sleep Sleep Disord Res. 2016;39:A35. Carter JR, Grimaldi D, Fonkoue IT, Medalie L, Whitmore H, Msallek S, et al. Sympathetic neural and cardiovascular control in chronic insomnia. J Sleep Sleep Disord Res. 2016;39:A180. Meerlo P, Sgoifo A, Suchecki D. Restricted and disrupted sleep: effects on autonomic function, neuroendocrine stress systems and stress responsivity. Sleep Med Rev. 2008;12(3):197–210. Lovallo WR, Gerin W. Psychophysiological reactivity: mechanisms and pathways to cardiovascular disease. Psychosom Med. 2003;65(1):36–45. Schwartz AR, et al. Toward a causal model of cardiovascular responses to stress and the development of cardiovascular disease. Psychosom Med. 2003;65(1):22–35. Murray DP, et al. Vascular function is not impaired early in the course of bipolar disorder. J Psychosom Res. 2012;72(3):195–8. Riemann D, et al. The hyperarousal model of insomnia: a review of the concept and its evidence. Sleep Med Rev. 2010;14(1):19–31. Perlis M, et al. Psychophysiological insomnia: the behavioural model and a neurocognitive perspective. J Sleep Res. 1997;6(3):179–88. • Palagini L, et al. Sleep loss and hypertension: a systematic review. Curr Pharm Des. 2013;19(13):2409–19. This systematic review proproses that sleep duration, sleep deprivation and persistent insomnia are linked with increased risk of hypertension. Wager-Smith K, Markou A. Depression: a repair response to stress-induced neuronal microdamage that can grade into a chronic neuroinflammatory condition? Neurosci Biobehav Rev. 2011;35(3):742–64. Robillard R, Hermens DF, Naismith SL, White D, Rogers NL, Ip TKC, et al. Ambulatory sleep-wake patterns and variability in young people with emerging mental disorders. J Psychiatry Neurosci. 2015;40(1):28. Seleem MA, et al. The longitudinal course of sleep timing and circadian preferences in adults with bipolar disorder. Bipolar Disord. 2015;17(4):392–402. Geoffroy PA, et al. Sleep in patients with remitted bipolar disorders: a meta-analysis of actigraphy studies. Acta Psychiatr Scand. 2015;131(2):89–99. Huynh C, et al. Sleep-wake patterns of adolescents with borderline personality disorder and bipolar disorder. Child Psychiatry Hum Dev. 2016;47(2):202–14. Kanady JC, Soehnera AM, Harvey AG. A retrospective examination of sleep disturbance across the course of bipolar disorder. J Sleep Disord Ther. 2015;4(2):1000193. Robillard R, Naismith SL, Rogers NL, Ip TKC, Hermens DF, Scott EM, et al. Delayed sleep phase in young people with unipolar or bipolar affective disorders. J Affect Disord. 2013;145(2):260–3. Dallaspezia S, Benedetti F. Chronobiology of bipolar disorder: therapeutic implication. Curr Psychiatry Rep. 2015;17(8):606. Melo MC, et al. Chronotype and circadian rhythm in bipolar disorder: a systematic review. Sleep Med Rev. 2017;34:46–58. Girshkin L, et al. Morning cortisol levels in schizophrenia and bipolar disorder: a meta-analysis. Psychoneuroendocrinology. 2014;49:187–206. Fares S, et al. Clinical correlates of chronotypes in young persons with mental disorders. Chronobiol Int. 2015;32(9):1183–91. Girshkin L, et al. Diurnal cortisol variation and cortisol response to an MRI stressor in schizophrenia and bipolar disorder. Psychoneuroendocrinology. 2016;67:61–9. Fukuyama H, Uchimura N. Changes in rectal temperature rhythm on manic states of bipolar patients. 久留米大学文学部紀要, 社会福祉学科編 (Faculty of Letters, Kurume University, ed), 2011; 10: 53–8. Zanini MA, et al. Abnormalities in sleep patterns in individuals at risk for psychosis and bipolar disorder. Schizophr Res. 2015;169(1):262–7. Cretu JB, et al. Sleep, residual mood symptoms, and time to relapse in recovered patients with bipolar disorder. J Affect Disord. 2016;190:162–6. Kaplan KA, et al. Hypersomnia subtypes, sleep and relapse in bipolar disorder. Psychol Med. 2015;45(08):1751–63. Leibenluft E, et al. Relationship between sleep and mood in patients with rapid-cycling bipolar disorder. Psychiatry Res. 1996;63(2):161–8. Saunders EF, et al. The effect of poor sleep quality on mood outcome differs between men and women: a longitudinal study of bipolar disorder. J Affect Disord. 2015;180:90–6. Raison CL, et al. Chronic interferon-alpha administration disrupts sleep continuity and depth in patients with hepatitis C: association with fatigue, motor slowing, and increased evening cortisol. Biol Psychiatry. 2010;68(10):942–9. Prather AA, et al. Cytokine-induced depression during IFN-α treatment: the role of IL-6 and sleep quality. Brain Behav Immun. 2009;23(8):1109–16. Cappuccio FP, et al. Meta-analysis of short sleep duration and obesity in children and adults. Sleep. 2008;31(5):619–26. Spiegel K, Leproult R, Van Cauter E. Impact of sleep debt on metabolic and endocrine function. Lancet. 1999;354(9188):1435–9. Scheer FA, et al. Adverse metabolic and cardiovascular consequences of circadian misalignment. Proc Natl Acad Sci. 2009;106(11):4453–8. Kerkhofs M, et al. Sleep restriction increases blood neutrophils, total cholesterol and low density lipoprotein cholesterol in postmenopausal women: a preliminary study. Maturitas. 2007;56(2):212–5. Sauvet F, et al. Effect of acute sleep deprivation on vascular function in healthy subjects. J Appl Physiol (1985). 2010;108(1):68–75. Zhong X, et al. Increased sympathetic and decreased parasympathetic cardiovascular modulation in normal humans with acute sleep deprivation. J Appl Physiol (1985). 2005;98(6):2024–32. Kato M, et al. Effects of sleep deprivation on neural circulatory control. Hypertension. 2000;35(5):1173–5. Ogawa Y, et al. Total sleep deprivation elevates blood pressure through arterial baroreflex resetting: a study with microneurographic technique. Sleep. 2003;26(8):986–9. Tochikubo O, et al. Effects of insufficient sleep on blood pressure monitored by a new multibiomedical recorder. Hypertension. 1996;27(6):1318–24. Robillard R, et al. Sleep deprivation increases blood pressure in healthy normotensive elderly and attenuates the blood pressure response to orthostatic challenge. Sleep. 2011;34(3):335–9. Amir O, et al. Brachial artery endothelial function in residents and fellows working night shifts. Am J Cardiol. 2004;93(7):947–9. Virtanen I, et al. Cardiac autonomic changes after 40 hours of total sleep deprivation in women. Sleep Med. 2015;16(2):250–7. Sunbul M, et al. Acute sleep deprivation is associated with increased arterial stiffness in healthy young adults. Sleep Breath. 2014;18(1):215–20. Muenter N, et al. Effect of sleep restriction on orthostatic cardiovascular control in humans. J Appl Physiol. 2000;88(3):966–72. Mullington JM, et al. Cardiovascular, inflammatory, and metabolic consequences of sleep deprivation. Prog Cardiovasc Dis. 2009;51(4):294–302. Chae CU, et al. Blood pressure and inflammation in apparently healthy men. Hypertension. 2001;38(3):399–403. Liu R, et al. Association between sleep quality and C-reactive protein: results from national health and nutrition examination survey, 2005–2008. PLoS One. 2014;9(3):e92607. Miller MA, et al. Gender differences in the cross-sectional relationships between sleep duration and markers of inflammation: Whitehall II study. Sleep. 2009;32(7):857–64. Ferrie JE, et al. Associations between change in sleep duration and inflammation: findings on C-reactive protein and interleukin 6 in the Whitehall II Study. Am J Epidemiol. 2013;178(6):956–61. Cappuccio FP, et al. Quantity and quality of sleep and incidence of type 2 diabetes a systematic review and meta-analysis. Diabetes Care. 2010;33(2):414–20. Xiao Q, et al. A large prospective investigation of sleep duration, weight change, and obesity in the NIH-AARP Diet and Health Study cohort. Am J Epidemiol. 2013;178(11):1600–10. Gangwisch JE, et al. Short sleep duration as a risk factor for hypertension analyses of the first national health and nutrition examination survey. Hypertension. 2006;47(5):833–9. King CR, et al. Short sleep duration and incident coronary artery calcification. JAMA. 2008;300(24):2859–66. Kinuhata S, et al. Sleep duration and the risk of future lipid profile abnormalities in middle-aged men: the Kansai Healthcare Study. Sleep Med. 2014;15(11):1379–85. Petrov M, et al. Longitudinal associations between objective sleep and lipids: the CARDIA study. Sleep. 2013;36(11):1587–95. Gottlieb DJ, et al. Association of usual sleep duration with hypertension: the Sleep Heart Health Study. Sleep. 2006;29(8):1009. Choi K, et al. Relationship between sleep duration and the metabolic syndrome: Korean National Health and Nutrition Survey 2001. Int J Obes. 2008;32(7):1091–7. Kaneita Y, et al. Associations of usual sleep duration with serum lipid and lipoprotein levels. Sleep. 2008;31(5):645–52. Bjorvatn B, et al. The association between sleep duration, body mass index and metabolic measures in the Hordaland Health Study. J Sleep Res. 2007;16(1):66–76. Rodríguez-Colón SM, et al. Sleep variability and cardiac autonomic modulation in adolescents—Penn State Child Cohort (PSCC) study. Sleep Med. 2015;16(1):67–72. Boudreau P, Dumont GA, Boivin DB. Circadian adaptation to night shift work influences sleep, performance, mood and the autonomic modulation of the heart. PLoS One. 2013;8(7):e70813. Vgontzas AN, et al. Chronic insomnia is associated with nyctohemeral activation of the hypothalamic-pituitary-adrenal axis: clinical implications. J Clin Endocrinol Metab. 2001;86(8):3787–94. Covassin N, et al. Cognitive performance and cardiovascular markers of hyperarousal in primary insomnia. Int J Psychophysiol. 2011;80(1):79–86. de Zambotti M, et al. Sleep onset and cardiovascular activity in primary insomnia. J Sleep Res. 2011;20(2):318–25. Lanfranchi PA, et al. Nighttime blood pressure in normotensive subjects with chronic insomnia: implications for cardiovascular risk. Sleep. 2009;32(6):760–6. Farina B, et al. Heart rate and heart rate variability modification in chronic insomnia patients. Behav Sleep Med. 2014;12(4):290–306. Somers VK, et al. Sleep apnea and cardiovascular disease: an American Heart Association/american College Of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council On Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). Circulation. 2008;118(10):1080–111. Wang X, et al. Obstructive sleep apnea and risk of cardiovascular disease and all-cause mortality: a meta-analysis of prospective cohort studies. Int J Cardiol. 2013;169(3):207–14. Phillips B. Sleep-disordered breathing and cardiovascular disease. Sleep Med Rev. 2005;9(2):131–40. Johansson P, et al. The contribution of hypoxia to the association between sleep apnoea, insomnia, and cardiovascular mortality in community-dwelling elderly with and without cardiovascular disease. Eur J Cardiovasc Nurs. 2015;14(3):222–31. Yamout K, et al. Neurocognitive correlates of nocturnal oxygen desaturation in a memory clinic population. J Clin Exp Neuropsychol. 2012;34(3):325–32. Sawatari H, Ando S, Nishizaka M, Miyazono M, Inoue S, Takemoto M, et al. The accumulated hypoxemia during sleep independently precited vascular endothelial dysfunction in patients with chronic heart failure. J Sleep Sleep Disord Res. 2016;39:A110. Shahar E, et al. Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med. 2001;163(1):19–25. Johansson P, et al. Sleep disordered breathing in an elderly community-living population: relationship to cardiac function, insomnia symptoms and daytime sleepiness. Sleep Med. 2009;10(9):1005–11. Gaines J, Vgontzas AN, Fernadez-Mendoza J, Calhoun SL, Liao D, Bixler EO. Inflammation in childhood predicts sleep apnea and blood pressure reactivity in adolescence: a longitudinal study. J Sleep Sleep Disord Res. 2016;39:A309. Franchi J-AM, et al. Les anomalies du sommeil peuvent-elles participer au risque cardio-vasculaire des troubles bipolaires? L'Encéphale. 2014;40:S40–5. Soreca I, et al. Chronotype and body composition in bipolar disorder. Chronobiol Int. 2009;26(4):780–8. Steinan MK, et al. Delayed sleep phase: an important circadian subtype of sleep disturbance in bipolar disorders. J Affect Disord. 2016;191:156–63. Soreca I, et al. The association between meal timing and frequency with cardiometabolic profile in patients with bipolar disorder. Acta Psychiatr Scand. 2016;133(6):453–8. Cudney LE, et al. Alterations in circadian rhythms are associated with increased lipid peroxidation in females with bipolar disorder. Int J Neuropsychopharmacol. 2014;17(5):715–22. Sitaram N, Gillin JC, Bunney WE Jr. The switch process in manic-depressive illness. Circadian variation in time of switch and sleep and manic ratings before and after switch. Acta Psychiatr Scand. 1978;58(3):267–78. Raj K, et al. Seasonal differences and circadian variation in stroke occurrence and stroke subtypes. J Stroke Cerebrovasc Dis. 2015;24(1):10–6. Argentino C, et al. Circadian variation in the frequency of ischemic stroke. Stroke. 1990;21(3):387–9. Marsh EE III, et al. Circadian variation in onset of acute ischemic stroke. Arch Neurol. 1990;47(11):1178–80. Prisco V, et al. Antipsychotic treatment and metabolic syndrome: a comparison between schizophrenic and bipolar patients. Eur Psychiatry. 2015;30:826. Newcomer JW. Comparing the safety and efficacy of atypical antipsychotics in psychiatric patients with comorbid medical illnesses. J Clin Psychiatry. 2009;70(suppl 3):30–6. Kelly T, et al. The high prevalence of obstructive sleep apnea among patients with bipolar disorders. J Affect Disord. 2013;151(1):54–8. Tamura H, et al. Melatonin treatment in peri- and postmenopausal women elevates serum high-density lipoprotein cholesterol levels without influencing total cholesterol levels. J Pineal Res. 2008;45(1):101–5. Scheer FA, et al. Daily nighttime melatonin reduces blood pressure in male patients with essential hypertension. Hypertension. 2004;43(2):192–7. Berk M, et al. Pathways underlying neuroprogression in bipolar disorder: focus on inflammation, oxidative stress and neurotrophic factors. Neurosci Biobehav Rev. 2011;35(3):804–17. Faraut B, et al. Immune, inflammatory and cardiovascular consequences of sleep restriction and recovery. Sleep Med Rev. 2012;16(2):137–49. Kilbourne AM, et al. Quality of care for cardiovascular disease-related conditions in patients with and without mental disorders. J Gen Intern Med. 2008;23(10):1628–33. Valenza G, et al. Wearable monitoring for mood recognition in bipolar disorder based on history-dependent long-term heart rate variability analysis. IEEE J Biomed Health Inform. 2014;18(5):1625–35. Delle Chiaie R, et al. Group psychoeducation normalizes cortisol awakening response in stabilized bipolar patients under pharmacological maintenance treatment. Psychother Psychosom. 2013;82(4):264–6.