Sleep and sleep-wake cycle in an 81-year-old patient with de novo ultra-rapid cycling bipolar disorder

  • Ralph Schreiner
  • Stephan Mirisch
  • Zdenko Vesely
  • Michael H. Wiegand
Original paper

DOI: 10.1007/s004060170064

Cite this article as:
Schreiner, R., Mirisch, S., Vesely, Z. et al. European Archives of Psychiatry and Clinical Neurosciences (2001) 251: 29. doi:10.1007/s004060170064

Abstract

This is a case report of an 81-year-old man who developed de novo bipolar disorder with ultra-rapid cycling at the age of 80. Mood was self-rated daily over a period of ten weeks; in addition, polysomnographic and motor activity recordings were performed during a drug-free baseline period. Both depressive and hypomanic episodes had an average duration of about 30 hours; the affective cycle was thus independent from the sleep-wake cycle. When mood shifts occurred during nighttime, sleep was different in nights following depression than in nights following hypomania. Positron emission tomography revealed a moderate bilateral frontal hypermetabolism in the hypomanic phase and yielded normal findings for the depressive stage. In contrast to what is usually expected in ultra-rapid cycling bipolar disorder, this case demonstrates an unusual sleep-unrelated cycle duration in the oldest reported patient so far.

Key words Bipolar disorder Ultra-rapid cycling Sleep-wake pattern Polysomnography Positron emission tomography 

Copyright information

© Steinkopff Verlag 2001

Authors and Affiliations

  • Ralph Schreiner
    • 1
  • Stephan Mirisch
    • 1
  • Zdenko Vesely
    • 1
  • Michael H. Wiegand
    • 1
  1. 1.Department of Neurology and Clinical Neurophysiology, Städtisches Krankenhaus München-Bogenhausen, Englschalkinger Strasse 77, 81925 Munich, Germany, e-mail: Ralph.Schreiner@lrz.tum.deDE