The Impacts of Chronotype on Sleep Quality, Eating Attitudes, and Cardiovascular Risk in Patients with Bipolar Disorder

Objective: The study aimed to investigate the relationship between chronotype and sleep quality, eating attitudes and cardiovascular disease (CVD) risk in bipolar disorder (BD). Methods: The study included data on sociodemographic and clinical variables, anthropometric measurements, and blood biochemical tests of 78 individuals in the euthymic period diagnosed with BD. Morningness-Eveningness Questionnaire (MEQ), Pittsburgh Sleep Quality Index (PSQI), and Eating Attitudes Test-40 (EAT-40) were administered to the participants. The internet-based Systematic Coronary Risk Evaluation-2 (SCORE-2) calculator was used as a cardiovascular risk assessment tool, and the presence of metabolic syndrome (MetS) was assessed. Results: Participants were divided into three chronotype groups: morning (n=25, 32.1%), intermediate (n=26, 33.3%) and evening type (n=27, 34.6%). The evening chronotype had significantly higher systolic blood pressure levels compared to the morning chronotype (p=0.050). Lower HDL (High-Density Lipoprotein) levels were observed in the evening chronotype group, while there was no significant difference in other biochemical parameters. 89% of the evening group had poor sleep quality. Two thirds of individuals in the evening group had MetS. After adjusting for confounding factors, it was observed that evening-type individuals had higher SCORE-2 scores compared to the non-evening-type group. Conclusion: In conclusion, late chronotype in BD is associated with poorer clinical prognosis and sleep quality, unhealthier dietary habits and higher risk of CVD. The development of chronobiological treatment interventions targeting circadian regulation may be beneficial for evening chronotype diagnosed with bipolar disorder.