Journal
CHRONOBIOLOGY INTERNATIONAL
Volume 37, Issue 6, Pages 887-896Publisher
TAYLOR & FRANCIS INC
DOI: 10.1080/07420528.2020.1746799
Keywords
Bipolar disorder; manic symptom; light at night; dark; circadian rhythm
Categories
Funding
- Japan Foundation for Neuroscience and Mental Health
- Neuroscience Research Center
- JSPS KAKENHI [18K15529]
- Grants-in-Aid for Scientific Research [18K15529] Funding Source: KAKEN
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Previous studies have found that keeping the room dark at night was associated with a decrease in manic symptoms for patients with bipolar disorder (BD). However, the association between light at night of real-life conditions and manic symptoms is unclear. We investigated the association between bedroom light exposure at night and manic symptoms in BD patients. One-hundred and eighty-four outpatients with BD participated in this cross-sectional study. The average light intensity at night during sleep was evaluated using a portable photometer for seven consecutive nights. Manic symptoms were assessed using the Young Mania Rating Scale (YMRS), and scores >= 5 were treated as a hypomanic state. The median (interquartile range) YMRS score was 2.0 (0-5.0), and 52 (28.2%) participants were in a hypomanic state. The prevalence of a hypomanic state was significantly higher in the participants with an average light intensity at night exposure of >= 3 lux than in those with <3 lux (36.7% versus 21.9%; P = .02). In multivariable logistic regression analysis adjusted for BD type, depressive symptoms, sleep duration, and daytime physical activity, the odds ratio (OR) for a hypomanic state was significantly higher for the participants with an average light intensity at night exposure of >= 3 lux than for those with <3 lux (OR: 2.15, 95% confidence interval: 1.09-4.22, P = .02). This association remained significant at the cutoff value of YMRS score >= 6 (OR: 2.51, 95% confidence interval: 1.15-5.46; P = .02). The findings of this study indicate bedroom light exposure at night is significantly associated with manic symptoms in BD patients. Although the results of this cross-sectional investigation do not necessarily imply causality, they may serve to inform beneficial nonpharmacological intervention and personalized treatment of BD patients.
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