Sleep improvement in hospital greater for those with acute mania compared with MDD

Key takeaways:

• For those with mania, sleep duration at admission was negatively correlated with length of hospitalization.
• The results suggest that short sleep duration could be a feature of the psychopathology of mania.

Individuals with mania who were admitted to an acute care psychiatric unit saw greater sleep improvement than patients with major depressive disorder, according to a study.

“Evidence suggests that sleep disturbance escalates just prior to an episode of mania,” Raphael Golebiowski, MD, of the Center for Sleep Medicine at the Mayo Clinic, and colleagues wrote in the Primary Care Companion for CNS Disorders. “Hospitalization is often necessary for the management of manic episodes.”

Golebiowski and colleagues sought to examine sleep duration at both admission and discharge, along with change in sleep duration during hospitalization in those experiencing a manic episode. They compared these parameters with those hospitalized for major depressive disorder (MDD) during the same time frame.

Their retrospective study examined patients admitted to the acute care psychiatric unit of the Mayo Clinic in Rochester, Minnesota, from 2018 to 2021, with either an episode of mania (n = 41; mean age, 32.9±1.7 years) or MDD (n = 38; mean age 32.7±1.8 years). Sleep duration was determined based on nursing observer reports in 15-minute intervals and calculated by averaging total sleep time on the second and third days of admission as well as by averaging total sleep time on the third and second days ahead of discharge. Additional patient data was collected regarding medication information such as prescription of hypnotics, antipsychotic and benzodiazepine dosage, voluntary or involuntary hospitalization, sex, age and comorbid substance use.

According to results, individuals with a diagnosis of mania served longer hospitalization and received higher antipsychotic and benzodiazepine doses, but fewer hypnotics, than those with an MDD diagnosis.

Change in sleep duration was 1.14±0.27 and 0.37±0.28 hours in the groups, respectively. For individuals with mania, sleep duration at admission was negatively correlated with length of stay (r=–0.033), although sleep duration parameters were not correlated with length of stay in patients with MDD.

Additionally, researchers found no differences in sleep duration at either admission or discharge in the mania and MDD groups.

“Sleep duration at admission negatively correlated with length of hospital stay in patients with mania but not with [major depressive disorder], suggesting that short sleep duration is a major feature of the underlying psychopathology,” Golebiowski and colleagues wrote.