- 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.