Night Terrors & Bipolar Disorder - Update
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Q:  Night Terrors & Bipolar Disorder - Update

I understand that night terrors can be associated with bipolar disorder. 

 #1 Can ad's aggravate a person to having night terrors more often? 

 #2 Do night terrors have any relation to cycling (ie depressed or manic phase?)

Any thoughts?

Dear Ms. C' -- 
Quite a few thoughts, yes, though I fear they'll not be of much use to you. First, the association between night terrors and bipolar disorder. I wonder where you saw/heard/read that?  I have one patient with night terrors who also has recurrent depression. She has other temperamental features that have always made me wonder about bipolar disorder, though she continues to do well on an antidepressant, now about 10 years running. I have only one other patient with night terrors, so not much other clinical experience to go by. 

So I did a search on PUB MED for night terrors bipolar and found one study which actually seems perfectly designed to address the question (mine, spurred by yours) of how often night terrors are seen with bipolar disorder. Interestingly, there was no association; although there was an extremely strong association for another related "parasomnia", which they referred to as "confusional arousals" but distinguished from night terrors. Here's the reference: Ohayon, Guilleminault, and Priest.  So this study does not confirm what you'd heard, the association of night terrors and bipolar disorder (if you have a reference for that, or some source, write and let me know?)

So for your questions, you can see that I have little experience and no psychiatric literature to refer to, in answer. Sorry about that. 

Dr. Phelps

Published February, 2006


Ms. C' went and dug up the article we were both referring to, good on her! and here's what we find, looking a little more deeply at whether there's a connection between bipolar disorder and night terrors: despite the authors' abstract indicating no relationship, at least to my read, in the paper we find a pretty clear connection. The authors conclude: "In the case of bipolar disorders..., even when possible interactions with sleep disturbances are controlled, bipolar disorders appear as an independent risk factor." 

So Ms. C was right, there is a connection. Whereas the rate of night terrors (in this large sample of the general population in the United Kingdom) was 2.2%, the rate in those with a bipolar diagnosis was 10.7%.  The distinction between these two groups was not divided out by age, so how many of those extra cases, in people with bipolar disorder, were in kids (who have a much higher rate of night terrors even without bipolar disorder) is not addressed in this article.  Thanks to Ms. C' for the follow-up! 

Dr. Phelps

Published March, 2006


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