Nicotine use and non-pathological alcohol use and their relationship to affective symptoms and sleep disturbances in bipolar disorder

Stine Holmstul Glastad; Sofie Ragnhild Aminoff; Roger Hagen; Margrethe Collier Høegh; Camilla Bakkalia Büchmann; Elizabeth Ann Barrett; Ingrid Melle; Bruno Etain; Trine Vik Lagerberg

doi:10.1016/j.jad.2023.02.003

Nicotine use and non-pathological alcohol use and their relationship to affective symptoms and sleep disturbances in bipolar disorder

J Affect Disord. 2023 Apr 14:327:236-243. doi: 10.1016/j.jad.2023.02.003. Epub 2023 Feb 4.

Authors

Stine Holmstul Glastad¹, Sofie Ragnhild Aminoff², Roger Hagen³, Margrethe Collier Høegh⁴, Camilla Bakkalia Büchmann⁴, Elizabeth Ann Barrett², Ingrid Melle⁴, Bruno Etain⁵, Trine Vik Lagerberg⁴

Affiliations

¹ NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway. Electronic address: s.h.olsen@ous-research.no.
² NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway; Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
³ Department of Psychology, University of Oslo, Oslo, Norway; Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway; Research institute, Modum Bad, Vikersund, Norway.
⁴ NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway.
⁵ INSERM U1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France; Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France; Université Paris Cité, Paris, France; Fondation FondaMental, Créteil, France.

PMID: 36746243
DOI: 10.1016/j.jad.2023.02.003

Abstract

Background: The use of alcohol and nicotine can negatively impact the course of bipolar disorder (BD), but there is limited knowledge about how symptoms and sleep disturbances are related to concurrent nicotine use and non-pathological use of alcohol.

Methods: We investigated how nicotine use and non-pathological use of alcohol relates to affective symptoms and sleep disturbances in 453 participants with BD without substance use disorders. Manic symptoms were assessed with the Young Mania Rating Scale, and depressive symptoms with The Inventory of Depressive Symptomatology, Clinician-Rated (IDS-C). Sleep-related questions from IDS-C were used to create proxy variables for sleep disturbances, including Insomnia and Hypersomnia. Multinomial regression analysis was conducted to investigate the associations between nicotine use and sleep disturbances, controlling for possible confounders such as current use of illicit drugs and psychopharmacological treatment.

Results: Depressive and manic symptoms were not associated with the concurrent level of alcohol or nicotine use. Individuals with medium and high levels of daily nicotine use had higher risk of insomnia than those without. Non-pathological alcohol use was not associated with sleep disturbances.

Limitations: Sleep disturbances were based on items from the IDS-C questionnaire.

Conclusion: We found an elevated risk for insomnia in individuals with BD and medium or high levels of daily nicotine use. We found no association between the level of affective symptoms and the level of use of alcohol or nicotine. The direction of the relationship between nicotine use and insomnia needs clarification, as it is highly relevant for treatment planning.

Keywords: Affective symptoms; Alcohol; Bipolar disorder; Nicotine; Sleep disturbances.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Affective Symptoms
Bipolar Disorder* / psychology
Humans
Nicotine
Sleep
Sleep Initiation and Maintenance Disorders* / complications

Substances

Nicotine