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Poor subjective sleep quality and trait impulsivity in patients with bipolar disorder

Published online by Cambridge University Press:  06 May 2024

Mao-Hsuan Huang
Department of Psychiatry, YuanShan and Suao Branches of Taipei Veterans General Hospital, Ilan, Taiwan Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan Institute of Brain Science, National Yang Ming Chao Tung University, Taipei, Taiwan
Yi-Hsuan Kuan
Institute of Brain Science, National Yang Ming Chao Tung University, Taipei, Taiwan
Yee-Lam E. Chan
Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
Wei-Chung Mao
Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
Tung-Ping Su*
Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan Institute of Brain Science, National Yang Ming Chao Tung University, Taipei, Taiwan Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
Corresponding author: Tung-Ping Su; Email:



Sleep disturbance and impulsivity are key components of mood vulnerability in bipolar disorder (BD), but few studies have assessed the association between these two symptoms among patients with BD.


Forty-seven euthymic patients with bipolar I disorder (BDI) or bipolar II disorder (BDII) and 58 age- and sex-matched healthy controls were enrolled in this cross-sectional study. Trait impulsivity was measured using the Barratt Impulsiveness Scale Version 11 (BIS-11), which yielded 3 second-order factors: attention, motor, and non-planning. Subjective sleep quality was assessed using the self-reported Pittsburgh Sleep Quality Index (PSQI). General linear models (GLMs) were used to assess the associations between subjective poor sleep and trait impulsivity with multiple testing corrections.


Patients with BD scored higher in BIS-11 and PSQI than healthy controls. PSQI total scores positively correlated with BIS-11 total scores, while sleep disturbance and daytime dysfunction were associated with attentional impulsiveness after controlling for covariates. Participants with higher PSQI total scores (>10) had higher scores in BIS-11 total, attention, and non-planning than those with low PSQI scores (≤5).


These findings support the hypothesis that poor sleep quality might lead to impulsivity and add to the growing evidence that improving sleep quality may be a therapeutic target for patients with BD.

Original Research
© The Author(s), 2024. Published by Cambridge University Press

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