Ottawa Sunglasses at Night for Mania Study

The Young Mania Rating Scale is used to evaluate the severity of manic symptoms at baseline and over time in individuals with mania. It is an 11-item scale and total score ranges from 0 to 60 where higher scores indicate more severe mania, thus, a negative change (or decrease) from baseline indicates a reduction (or improvement) in manic symptoms. Total score ≤12 indicates remission (13-19=minimal symptoms; 20-25=mild mania, 26-37=moderate mania, 38-60=severe mania). We will model differences between groups in the primary outcome using linear mixed models (group by time interaction) including a random intercept term for participant.

Medication use will be abstracted from the medication administration record to assess need for scheduled and as needed antipsychotics and benzodiazepines.

Medication use will be abstracted from Medication Administration Records of the Electronic Medical Record.

In a subsample of the study, validated monitors will also be used for non-invasive and wireless continuous monitoring of movements through wrist actigraphy (Actiwatch Spectrum Plus, Philips Healthcare, Bend, USA)

All items in the Patient Mania Questionnaire included time frame and stem-phrase format of "Over the past week, how often have you….". The Patient Mania Questionnaire item responses ranged from 0 to 3 with 0 indicating "not at all," 1 indicating "several days," 2 indicating "more than half of days," and 3 indicating "nearly every day." Item scores were added so that the total score ranged from 0 to 27 with higher scores representing greater severity.

The survey contains six items three items measure depressive symptoms (depressed mood, fidgeting, and fatigue), two items measure manic symptoms (increased energy, rapid speech), and one item measures both (irritability). Participants rate symptoms on an ordinal scale: 0 = absent/normal, 1 = mild, 2 = moderate, 3 = severe. Items can be aggregated into two scores to reflect depressive symptom severity and manic symptom severity. Higher depression and manic scores reflect more severe depressive and manic symptoms, respectively. Since item responses range from 0 to 3, the depression score ranges from 0 (no symptoms) to 21 (all depressive symptoms are severe), whereas the manic score ranges from 0 (no symptoms) to 15 (all manic symptoms are severe).

The Altman Self-Rating Mania Scale is a 5-item self-rating mania scale designed to assess the presence and/or severity of manic symptoms. Each item on the measure is rated on a 5-point scale (i.e., 1 to 5) with the response categories having different anchors depending on the item. The Altman Self-Rating Mania Scale score range from 5 to 25 with higher scores indicating greater severity of manic symptoms.

The scale is widely available and has two common versions with either 1 and is scored between 0 and 4 points. Scoring is based on the 17-item scale and scores of 0-7 are considered as being normal, 8-16 suggest mild depression, 17-23 moderate depression and scores over 24 are indicative of severe depression; the maximum score being 52 on the 17-point scale.

Self-reported measurement of the severity of depression symptoms experienced within the last two weeks. The survey consists of 9 items. Participants are asked to rate each symptom of depression on a Likert scale, providing a score between 0 (not at all) and 3 (nearly every day). This yields a total score ranging from 0 (minimal depression) to 27 (severe depression). Higher scores thus indicate a greater severity of depressive symptoms, and are interpreted in the following manner: a score of 0-4 indicates minimal depression, a score of 5-9 indicates mild depression, a score of 10-14 indicates moderate depression, a score of 15-19 indicates moderately severe depression, and a score of 20-27 indicates severe depression.

Self-reported measurement of the severity of anxiety symptoms experienced within the last two weeks. It consists of 7 scored items and one follow-up question. Each of the 7 scored items generates a value from 0 (not at all) to 3 (nearly every day), yielding a total score ranging from 0 to 21, with higher scores indicating more severe symptoms of anxiety. These scores are interpreted in the following manner: a score of 0-4 indicates little or no anxiety, a score of 5-9 indicates mild anxiety, a score of 10-14 indicates moderate anxiety, and a score of 15-21 indicates severe anxiety. Generally, a score of 10 or above is considered to be a clinical cutoff implying that the respondent may be suffering from a general anxiety disorder.

This questionnaire has 19 questions, each with a number of points. Scores can range from 16-86. Scores of 41 and below indicate "evening types." Scores of 59 and above indicate "morning types." Scores between 42-58 indicate "intermediate types."

The Pittsburg Sleep Quality Index Questionnaire is self-administered questionnaire designed to evaluate sleep quality consisting of 18 items that in turn are comprised of seven components, which include subjective sleep quality, sleep duration, sleep onset, habitual sleep efficiency, sleep disturbances, use of sleeping medications and daytime dysfunction. Each weighted equally on a 0-3 scale to be summed to yield a global PSQI score, which ranges between 0 and 21, where the higher the scores, the worse the sleep quality. The investigators will only be using questions 1-4 and 6.

The Leeds Sleep Evaluation Questionnaire comprises ten self-rating 100-mm-line analogue questions concerned with aspects of sleep and early morning behavior. A 10-cm line separates the two halves of each question. The questionnaire instructions are" "Each question is answered by placing a vertical mark on the answer line. If no change was experienced then place your mark in the middle of the line. If a change was experienced then the position of your mark will indicate the nature and extent of the change, i.e. large charges near the ends of the line, small changes near the middle." The questionnaire monitors subjectively perceived changes in sleep. Improvements in the self-reported ratings relate to improved perceived quality of sleep.

The Pre-Sleep Arousal Scale contains 16 items, each rated on a 5-point scale that describes symptoms of arousal at bedtime. Eight items evaluates cognitive arousal and eight evaluates somatic arousal. Total score scores range from 16 to 80, with higher scores suggest higher pre-sleep arousal.

Substudy for subsample (measured at Baseline and Week One)