Association between light exposure at night and manic symptoms in bipolar disorder: cross-sectional analysis of the APPLE cohort

ABSTRACT

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.     

Do you perform the multiple sleep latency test according to the guidelines? A case with multiple sleep onset REM periods

Sleep and Biological Rhythms - The patient was a 21-year-old male who complained of daytime sleepiness. His multiple sleep latency test (MSLT) showed multiple sleep onset REM periods (SOREMPs). The...     

Discontinuous DBH–height relationship of <Emphasis Type="Italic">Cryptomeria japonica</Emphasis> on Yakushima Island: effect of frequent typhoons on the maximum height

The mountain zone of Yakushima Island is covered with a mixed conifer-broadleaved forest dominated by old-growth Cryptomeria japonica (L.f.) D. Don trees. Even though Yakushima Island has been frequently struck by typhoons with wind velocities exceeding 55 m s⁻¹, the Cr. japonica trees in the mountain zone have survived for thousands of years without fatal damage. To evaluate the effect of storms on tree growth, the relationships between the stem diameter at breast height (DBH) and the heights of Cr. japonica and coexistent tree species were investigated. Two models based on an expanded allometric equation and a discontinuous piecewise allometric equation, respectively, to represent DBH–height relationships were evaluated. In all plots, the DBH–height relationship of Cr. japonica was discontinuous between small DBH and large DBH individuals. The tops of the large DBH individuals of Cr. japonica were lost to strong winds. However in each instance, they occupied the highest position in the canopy, even if they had lost their tops. In contrast, the DBH–height relationships of subcanopy broadleaved species were continuous in many plots and the equilibrium heights of the dominant broadleaved species were similar and almost in the same order regardless of the canopy heights of Cr. japonica. These results revealed a constant vertical structure in the Cr. japonica forest on Yakushima Island. Our results demonstrate a vertical niche segregation in the forest under high wind pressures and such vertical structure enables effective use of forest space and increases the basal area density.