Ambient and passive collection of sleep and circadian rhythm data in bipolar disorder to understand symptom trajectories and clinical outcomes (AMBIENT-BD).

Bipolar disorder is defined by extreme variability in mood, activity, sleep and circadian timing recurring over weeks and months. To date, studies of sleep/circadian rhythms in bipolar disorder have been cross-sectional and based on only 1-2 weeks of monitoring: we urgently need new approaches that can assess longer-term individual-level changes in sleep, activity and mood, to better understand symptom trajectories and mechanisms of relapse. We will optimize innovative ambient and passive data collection methods over long time periods and test their feasibility and performance against gold standards. A lived experience advisory panel will help us to identify and prioritize clinical and functional outcome measures and develop 'low intensity' methods for collecting these outcomes. In parallel, we will develop a data collection and management system to support data collection and optimize data sharing with patients, clinicians and the research community. The core of this project is an 18-month prospective follow-up study of sleep, circadian rhythms and clinical/functional outcomes in people with bipolar disorder that primarily makes use of low intensity ambient and passive data collection methods. We will also work with Bipolar Scotland to co-produce an innovative programme of knowledge exchange on the theme of 'Sleep, circadian rhythms and bipolar disorder'.