Sleep disturbance in bipolar disorder: therapeutic implications

Am J Psychiatry. 2008 Jul;165(7):830-43. doi: 10.1176/appi.ajp.2008.08010077. Epub 2008 May 15.

Abstract

In this review, the authors detail our current understanding of the crucial role that sleep and its disturbances play in bipolar disorder. Multiple lines of evidence suggest that impaired sleep can induce and predict manic episodes. Similarly, treatment of sleep disturbance may serve as both a target of treatment and a measure of response in mania. The depressive phase of bipolar illness is marked by sleep disturbance that may be amenable to somatic therapies that target sleep and circadian rhythms. Residual insomnia in the euthymic period may represent a vulnerability to affective relapse in susceptible patients. Given the importance of sleep in all phases of bipolar disorder, appropriate evaluation and management of sleep disturbance in patients with bipolar illness is further detailed.

Publication types

  • Review

MeSH terms

  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / epidemiology*
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / epidemiology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Homeostasis / physiology
  • Humans
  • Polysomnography
  • REM Sleep Behavior Disorder / diagnosis
  • REM Sleep Behavior Disorder / epidemiology*
  • REM Sleep Behavior Disorder / physiopathology
  • Sleep Deprivation / diagnosis
  • Sleep Deprivation / epidemiology
  • Sleep Deprivation / physiopathology
  • Sleep Disorders, Circadian Rhythm / diagnosis
  • Sleep Disorders, Circadian Rhythm / epidemiology*
  • Sleep Disorders, Circadian Rhythm / physiopathology
  • Sleep Initiation and Maintenance Disorders / diagnosis
  • Sleep Initiation and Maintenance Disorders / epidemiology*
  • Sleep Initiation and Maintenance Disorders / physiopathology