Familiality and clinical outcomes of sleep disturbances in major depressive and bipolar disorders

Yin Chieh Lai, Ming Chyi Huang, Hsi Chung Chen, Ming Kun Lu, Yi Hang Chiu, Winston W. Shen, Ru Band Lu, Po Hsiu Kuo

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)


Objective: Sleep disturbances are frequently observed in major depressive (MDD) and bipolar disorder (BD). This study reported sleep profiles of patients and their relatives versus controls, and examined the familiality of sleep features in mood disorder families. We also evaluated the influences of sleep disturbance on patients' quality of life (QOL), functional impairment, and suicidality. Methods: We recruited 363 BD and 157 MDD patients, 521 first-degree relatives, and 235 healthy controls, which completed a diagnostic interview, Pittsburgh Sleep Quality Index (PSQI), and QOL questionnaire. The magnitude of heritability of sleep features was calculated and familiality was evaluated by mixed regression models and intraclass correlation coefficient (ICC). The associations between sleep problems and clinical outcomes were examined using multiple regression models. Results: More than three-quarters of mildly-ill patients were classified as "poor sleepers". MDD patients had significantly worse sleep quality as compared to BD patients. Moderate but significant familial aggregation was observed in subjective sleep quality, sleep latency, disturbance, daytime dysfunction, and global score (ICC=0.10-0.21, Padj=2.8) and suicide attempts (ORadj=1.9-2.8). Conclusion: Subjectively measured sleep features demonstrated significant familiality. Poor sleep quality further impaired patients' daily function and QOL, in addition to increasing the risk of suicidality, and thus requires special attention in related clinical settings.

Original languageEnglish
Pages (from-to)61-67
Number of pages7
JournalJournal of Psychosomatic Research
Issue number1
Publication statusPublished - Jan 2014


  • Bipolar disorder
  • Familial aggregation
  • Major depressive disorder
  • Quality of life
  • Sleep disturbance

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology


Dive into the research topics of 'Familiality and clinical outcomes of sleep disturbances in major depressive and bipolar disorders'. Together they form a unique fingerprint.

Cite this