The purpose of this K01 Mentored Research Scientist Development Award application is to facilitate my training in the field of sleep and pediatric bipolar disorder (PBD) and in so doing, support my short-term objectives to: (1) comprehensively characterize sleep and circadian rhythms in adolescents with bipolar disorder (BD), and (2) investigate the relationship between sleep/circadian dysregulation and mood dysregulation in this population. The proposed training and research project represent the key first step in laying the groundwork for a long-term independent, academic, clinical research career focused on sleep and circadian dysregulation in the onset, development, course, and treatment of pediatric mood disorders. Multiple lines of evidence suggest that sleep/circadian disruptions are core features of adult BD, and that these disruptions may trigger episodes of illness. However, there is virtually no information on the nature and severity of sleep/circadian disruption in PBD, or on the potential contribution of sleep/circadian disruption to mood dysregulation. Given incidence rates of BD peak during adolescence and that BD is associated with particularly devastating outcomes when onset is early in life, adolescence offers a critical window for understanding the development of this disorder. Previous studies assessing sleep and circadian functioning in PBD samples have largely relied on subjective measures. The proposed research study will be the first to use a comprehensive, ecologically sensitive, and objective characterization of sleep/circadian rhythms in adolescents with BD relative to controls. This assessment combines two nights of ambulatory polysomnography (PSG), along with a two- week observation period of continuous actigraphy, and daily monitoring of subjective sleep, social rhythms, and affect. Daily measures of social interaction, stress, and rumination will also be collected. By investigating sleep in bipolar youth, the proposed study aims to address a gap in knowledge on the role of sleep and circadian disruption in the early development and progression of PBD. The hypotheses predict group differences in: (H1a) sleep architecture, specifically sleep efficiency, REM latency, and REM density and duration; (H1b) sleep and wake durations, sleep fragmentation, and daytime activity level; (H1c) overall rates of sleep disorders; (H1d) subjective sleep measures and regularity of social rhythms. The proposed investigation will also examine a potential link between daily sleep and daily affect in order to test for group differences in (H2) the degree of sleep-affect coupling. The proposed integrated program of research, mentorship and didactic training, combined with the outstanding research environment at Stanford University will foster my long-term career objective to be an independent investigator of sleep and circadian mechanisms in pediatric mood disorders.

Public Health Relevance

There has been limited investigation of sleep and circadian rhythms in youth with bipolar disorder. Comprehensive and ecologically valid approaches are required to provide a characterization of sleep and circadian rhythms in relation to mood in bipolar disorder. The proposed research will help identify sleep and circadian factors that may ultimately improve the identification of, and long-term outcomes for, youth with bipolar disorder.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Scientist Development Award - Research & Training (K01)
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Child Psychopathology and Developmental Disabilities Study Section (CPDD)
Program Officer
Sarampote, Christopher S
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Stanford University
Schools of Medicine
United States
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Gershon, Anda; Johnson, Sheri L; Thomas, Leigh et al. (2018) Double trouble: weekend sleep changes are associated with increased impulsivity among adolescents with bipolar I disorder. Bipolar Disord :
Kaufmann, Christopher N; Gershon, Anda; Depp, Colin A et al. (2018) Daytime midpoint as a digital biomarker for chronotype in bipolar disorder. J Affect Disord 241:586-591
Gershon, Anda; Kaufmann, Christopher N; Depp, Colin A et al. (2018) Subjective versus objective evening chronotypes in bipolar disorder. J Affect Disord 225:342-349
Gershon, Anda; Hayward, Laura; Donenberg, Geri R et al. (2018) Victimization and traumatic stress: Pathways to depressive symptoms among low-income, African-American girls. Child Abuse Negl 86:223-234
Gershon, Anda; Singh, Manpreet K (2017) Sleep in Adolescents With Bipolar I Disorder: Stability and Relation to Symptom Change. J Clin Child Adolesc Psychol 46:247-257
Gershon, Anda; Do, Dennis; Satyanarayana, Satyanand et al. (2017) Abnormal sleep duration associated with hastened depressive recurrence in bipolar disorder. J Affect Disord 218:374-379
Gershon, Anda; Ram, Nilam; Johnson, Sheri L et al. (2016) Daily Actigraphy Profiles Distinguish Depressive and Interepisode States in Bipolar Disorder. Clin Psychol Sci 4:641-650
Johnson, Sheri L; Cuellar, Amy K; Gershon, Anda (2016) The Influence of Trauma, Life Events, and Social Relationships on Bipolar Depression. Psychiatr Clin North Am 39:87-94
Kaufmann, Christopher N; Gershon, Anda; Eyler, Lisa T et al. (2016) Clinical significance of mobile health assessed sleep duration and variability in bipolar disorder. J Psychiatr Res 81:152-9
Primeau, Michelle; Gershon, Anda; Talbot, Lisa et al. (2016) Individuals with Autism Spectrum Disorders Have Equal Success Rate But Require Longer Periods of Systematic Desensitization than Control Patients to Complete Ambulatory Polysomnography. J Clin Sleep Med 12:357-62

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