Mania triggered by sleep loss could be a marker for postpartum psychosis
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The risk for postpartum psychosis (PP) should be monitored in women with bipolar disorder (BD) who are pregnant or planning to conceive.
Sleep loss with a history of mood dysregulation can be a marker of increased risk for PP.
Why this matters
PP is common during the first 2 postpartum wk and has a sudden onset.
Loss of sleep exerts an antidepressant effect by resetting processes that are a result of abnormal clock genes.
This retrospective study evaluated 870 parous women with BD between November 2007 and July 2013.
Funding: Stanley Medical Research Institute and others.
220 women reported sleep loss had triggered mania, 595 reported sleep loss had not triggered mania and 55 were unsure whether sleep loss had triggered mania.
Mania triggered by sleep loss and PP showed significant association when separating women based on the first episode experienced in relation to childbirth (OR, 2.91; P=.011) or unrelated to childbirth (OR, 2.45; P<.001).
Significantly higher risk for PP was seen in women reporting sleep loss triggering mania (P<.001).
Lifetime episode of PP is most common in women reporting sleep loss triggering mania (OR, 2.09; P<.001).
Risk for bias.
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