BACKGROUND: Impairment of sleep and circadian rhythm is a typical feature of bipolar disorder (BD). We carried out an exploratory cross-sectional case-control study to extend the knowledge of sleep characteristics in offspring at risk for BD. METHODS: We investigated 42 offspring of bipolar parents (OB) (mean age 12.5 ± 3.2) and 42 sex and age matched comparison offspring of healthy parents. We administered the Pediatric Sleep Questionnaire, the Morningness/Eveningness Questionnaire and The General Behavior Inventory Sleep Subscale (GBISS) to assess circadian preference, and to identify sleep impairment symptoms. In addition, the participants completed 14 days of actigraphy to characterise sleep and wake patterns. The current psychopathology profile was assessed using Kiddie Schedule for Affective Disorders and Schizophrenia. RESULTS: Prevalence of sleep disturbance symptoms was higher among OB than controls (headache after waking up, 17.9% vs. 2.4%, p = 0.03; excessive daytime sleepiness, 38.5% vs. 10.0%, p = 0.004; apparent tiredness at wake-up times, 43.6% vs. 15.0%, p = 0.007 and nightmares, 21.6% vs. 2.4%, p = 0.01), but the differences between groups were not significant after adjusting for current psychopathology. OB had higher GBISS total score (parental version, p < 0.001; self-assessment, p = 0.07) than the controls. OB had higher preference for eveningness than the controls (p = 0.047). According to the actigraphy, OB had longer sleep onset latency (p = 0.048) than the controls. CONCLUSION: Evidence suggests that the offspring of bipolar parents experience sleep disturbance symptoms, which was associated with psychopathology in this study. Prospective longitudinal sleep studies would clarify whether sleep disturbance could be a predictor of mood disorder onset in this high-risk population.

1st Faculty of Medicine Charles University Prague Katerinska 32 121 08 Prague 2 Czech Republic

2nd Faculty of Medicine Charles University Prague 5 Uvalu 84 5 15006 Prague Czech Republic

3rd Faculty of Medicine Charles University Prague Ruska 87 10 100 00 Prague Czech Republic

Department of Child and Adolescent Psychiatry Motol University Hospital 5 Uvalu 84 5 15006 Prague Czech Republic

Department of Neurology General Teaching Hospital and 1st Faculty of Medicine Charles University Prague Katerinska 30 128 21 Prague 2 Czech Republic

National Institute of Mental Health Topolova 748 250 67 Klecany Czech Republic

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