The relationship of sleep and sexual function in bipolar disorder during remission

BackgroundSleep disturbances and sexual dysfunction are common residual symptoms in bipolar disorder(BD) and may persist during remission. This study aimed to investigate the association between sleep quality and sexual functioning in patients with BD during remission.MethodsThe study included 200 outpatients with BD(100 women, 100 men)who were in remission Structured Clinical Interview for DSM-5 Disorders(SCID-5), Young Mania Rating Scale(YMRS), and Hamilton Depression Rating Scale(HDRS) criteria were used for clinical evaluations.Sleep quality and daytime sleepiness was assessed using the Pittsburgh Sleep Quality Index(PSQI) and Epworth Sleepiness Scale(ESS). Sexual functioning was evaluated with the Female Sexual Function Index(FSFI) in women and the International Index of Erectile Function-15(IIEF-15) in men.ResultsPoor sleep quality was observed in 45.5% of patients. Higher ESS and PSQI scores were associated with lower sexual-function scores in both sexes. Poor sleepers had significantly lower FSFI and IIEF scores, whereas categorical excessive daytime sleepiness was not associated with sexual-function scores. In adjusted sex-specific models, higher PSQI scores remained associated with lower FSFI and IIEF scores.ConclusionPoorer sleep quality was associated with poorer sexual functioning in both women and men with BD during remission.These findings support the clinical relevance of assessing sleep quality and sexual functioning concurrently.