Individuals with bipolar disorder (BD) have higher than average rates of coffee, tobacco and alcohol use. These substances may have deleterious effects on sleep quality and quantity, which may destabilize sleep/wake cycles and negatively impact the clinical course and prognosis of BD. The use of these substances may also be perceived as a self-medication attempt, for example, to induce sleep or to increase vigilance during the day. The objective of the current study was to investigate associations between the self-reported daily use of coffee, tobacco, and alcohol, and objective measures of sleep and activity patterns in adult individuals with BD. A sample of 147 euthymic individuals with BD were assessed for daily coffee, tobacco and alcohol consumption and 21 days of actigraphy monitoring. Actigraphic measures of sleep quantity and daytime activity were compared between groups classified as coffee+/coffee-, tobacco+/tobacco- and alcohol+/alcohol-, defined according to their current daily use. Then, we examined potential correlations between sleep/wake cycle parameters and the amount of daily consumption of each substance. Multivariable analyses identified associations between the use of coffee, tobacco, and alcohol and several sleep and activity parameters, such as between coffee, alcohol, and the relative amplitude of activity (respectively, p = .003 and p = .005), between alcohol and M10 onset (onset time of the 10 most active hours during the 24-h cycle) (p = .003), and between coffee and sleep duration (p = .047). This study supports the hypothesis that there is a relationship, whose direction would be bidirectional, between the daily use of these substances and the sleep/wake cycle in euthymic individuals with BD. These preliminary results require replications in other retrospective and prospective samples. They may have a clinical impact on psycho-education strategies to be proposed to individuals with BD.

双相情感障碍 (BD) 患者的咖啡、烟草和酒精使用率高于平均水平。这些物质可能会对睡眠质量和数量产生有害影响，从而破坏睡眠/觉醒周期的稳定性并对双相情感障碍的临床病程和预后产生负面影响。使用这些物质也可能被视为一种自我治疗尝试，例如，诱导睡眠或提高白天的警惕性。本研究的目的是调查成年双相情感障碍患者自我报告的每日咖啡、烟草和酒精的使用量与睡眠和活动模式的客观测量之间的关联。对 147 名心境正常的 BD 个体进行了每日咖啡、烟草和酒精消耗量以及 21 天体动记录仪监测的评估。对咖啡+/咖啡-、烟草+/烟草-和酒精+/酒精-（根据当前日常使用情况定义）的组之间的睡眠量和日间活动的活动记录测量进行了比较。然后，我们检查了睡眠/觉醒周期参数与每种物质的每日消耗量之间的潜在相关性。多变量分析确定了咖啡、烟草和酒精的使用与一些睡眠和活动参数之间的关联，例如咖啡、酒精与活动相对幅度（分别为p = .003 和p = .005）、酒精之间的关联和 M10 开始时间（24 小时周期内 10 个最活跃小时的开始时间）（ p = .003），以及咖啡和睡眠持续时间之间的时间（ p = .047）。这项研究支持这样的假设：在情绪正常的双相情感障碍患者中，这些物质的日常使用与睡眠/觉醒周期之间存在着双向关系。 这些初步结果需要在其他回顾性和前瞻性样本中进行复制。它们可能会对向双相情感障碍患者提出的心理教育策略产生临床影响。