24 Children or adolescents with dysthymic disorder are cranky, Irritable, depressed, pessimistic, and have poor social skills. Individuals with a family

history of major depression respond better to antidepressant medications than dysthymic individuals without this history.7 In about 25% to 50% of dysthymic adults, polysomnography findings are similar to those seen In MDD subjects, with shortened first NREM period, shortened REM latency, and Increased REM density.7,13 In a study Inhibitors,research,lifescience,medical of 12 hypersomnic dysthymic subjects, Dolenc et al reported excess stage 1 NREM sleep and reduced stages 3 and 4 NREM sleep on polysomnography; mean sleep latency on the mean sleep latency test (MSLT) was normal Inhibitors,research,lifescience,medical at 13±1 min.25 As In MDD, an unresolved Issue Is whether the sleep-related complaints are due to a clrcadian rhythm disturbance or to an Intrinsic sleep dysfunction. Bipolar disorder Bipolar

disorder affects 2.3 million Americans.1 Bipolar I disorder consists of one or more manic or mixed episodes kinase inhibitor KPT-330 usually accompanied by a major depressive Inhibitors,research,lifescience,medical episode.7,13 On the other hand, bipolar II disorder consists of one or more major depressive episodes accompanied by at least one hypomanic episode.7 Like dysthymia, bipolar II disorder Is more frequent In women, while bipolar I disorder does not have a gender difference. Compared with manic subjects, bipolar depression Is associated with higher sleep efficiency Polysomnographic findings Inhibitors,research,lifescience,medical In the depressed phase are similar to those of MDD. During the manic episode of either bipolar I or II disorder, a persistent and abnormally elevated, expansive mood lasting at least 1 week Is noted. Accompanying symptoms Include Inflated self-esteem or grandiosity, Increased talkativeness, flight of ideas, dlstractibllity,

psychomotor agitation, and an excess Involvement In pleasurable activities that have a high potential for painful consequences. During the manic phase, there Inhibitors,research,lifescience,medical Is decreased need for sleep (eg, subject Cilengitide feel rested after only 2 to 4 h of sleep). Polysomnography In manic subjects demonstrates markedly decreased total sleep time (TST), and short REM latency; stages 3 and 4 NREM sleep may be reduced.13,22 Cyclothymic disorder The manic and depressed phases of bipolar disorder are more severe than the mood fluctuations of cyclothymic disorder. The essential feature of this disorder is a chronic (at least 2 years’ duration In selleck catalog adults or at least 1 year’s duration In children and adolescents) fluctuating mood disturbance, with hypomanic symptoms and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode.7,13 During hypomanic episodes, there Is a profound Inability to fall asleep.