Skip to main content

Bipolar Disorder

  • Chapter
  • First Online:
Sleep Medicine

Abstract

The clinical observation of sleep alterations in mood disorders is really ancient and dates back to 400 AD with Hippocrates. Sleep disturbances and dysregulation of circadian rhythms are core elements in bipolar disorder. Indeed, stable sleep–wake cycles are of central importance to the maintenance of mood stability; sleep loss can trigger mania in patients and impaired sleep may represent a vulnerability to relapse into both pathological phases of illness.

Since the 1950s, many polysomnographic studies have been focusing on sleep characteristics in bipolar depression, finding alterations in electroencephalogram (EEG) sleep patterns. Several circadian rhythm theories have been proposed to explain the observed links between sleep physiology and depression.

Not only has the study of sleep contributed to the understanding of the disorder but also the manipulation of sleep through sleep deprivation has been demonstrated to be useful in the treatment of bipolar depression.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bauer M, Glenn T, Whybrow PC, et al. Changes in self-reported sleep duration predict mood changes in bipolar disorder. Psychol Med. 2008;38:1069–71.

    PubMed  Google Scholar 

  2. Bauer M, Grof P, Rasgon N, Bschor T, Glenn T, Whybrow PC. Temporal relation between sleep and mood in patients with bipolar disorder. Bipolar Disord. 2006;8:160–7.

    Article  PubMed  Google Scholar 

  3. Leibenluft E, Albert PS, Rosenthal NE, Wehr TA. Relationship between sleep and mood in patients with rapid-cycling bipolar disorder. Psychiatry Res. 1996;63:161–8.

    Article  CAS  PubMed  Google Scholar 

  4. Wehr TA, Sack DA, Norman E. Sleep reduction as a final common pathway in the genesis of mania. Am J Psychiatry. 1987;144:201–4.

    Article  CAS  PubMed  Google Scholar 

  5. Barbini B, Bertelli S, Colombo C, Smeraldi E. Sleep loss, a possible factor in augmenting manic episode. Psychiatry Res. 1996;15:121–5.

    Article  Google Scholar 

  6. Akiskal HS, Benazzi F. Atypical depression: a variant of bipolar II or a bridge between unipolar and bipolar II? J Affect Disord. 2005;84:209–17.

    Article  PubMed  Google Scholar 

  7. Detre TP, Himmelhoch JM, Swartzburg M, Anderson CM, Byck R, Kupfer DJ. Hypersomnia and manic—depressive disease. Am J Psychiatry. 1972;128:1303–5.

    Article  CAS  PubMed  Google Scholar 

  8. Leibenluft E, Clark CH, Myers FS. The reproducibility of depressive and hypomanic symptoms across repeated episodes in patients with rapid-cycling bipolar disorder. J Affect Disord. 1995;33:83–8.

    Article  CAS  PubMed  Google Scholar 

  9. Benca RM, Obermeyer WH, Thisted RA, Gillin JC. Sleep and psychiatric disorders. A meta-analysis. Arch Gen Psychiatry. 1992;49:651–68; discussion 69–70.

    Article  CAS  PubMed  Google Scholar 

  10. Kupfer DJ, Foster FG. Interval between onset of sleep and rapid-eye-movement sleep as an indicator of depression. Lancet. 1972;2:684–6.

    Article  CAS  PubMed  Google Scholar 

  11. Kupfer DJ. REM latency: a psychobiologic marker for primary depressive disease. Biol Psychiatry. 1976;11:159–74.

    CAS  PubMed  Google Scholar 

  12. Vogel GW, Vogel F, McAbee RS, Thurmond AJ. Improvement of depression by REM sleep deprivation. New findings and a theory. Arch Gen Psychiatry. 1980;37:247–53.

    Article  CAS  PubMed  Google Scholar 

  13. Giles DE, Rush AJ, Roffwarg HP. Sleep parameters in bipolar I, bipolar II, and unipolar depressions. Biol Psychiatry. 1986;21:1340–3.

    Article  CAS  PubMed  Google Scholar 

  14. Duncan WC, Jr., Pettigrew KD, Gillin JC. REM architecture changes in bipolar and unipolar depression. Am J Psychiatry. 1979;136:1424–7.

    Article  PubMed  Google Scholar 

  15. Van Sweden B. Disturbed vigilance in mania. Biol Psychiatry. 1986;21:311–3.

    Article  PubMed  Google Scholar 

  16. Linkowski P, Kerkhofs M, Rielaert C, Mendlewicz J. Sleep during mania in manic-depressive males. Eur Arch Psychiatry Neurol Sci. 1986;235:339–41.

    Article  CAS  PubMed  Google Scholar 

  17. Hudson JI, Lipinski JF, Frankenburg FR, Grochocinski VJ, Kupfer DJ. Electroencephalographic sleep in mania. Arch Gen Psychiatry. 1988;45:267–73.

    Article  CAS  PubMed  Google Scholar 

  18. Janowsky DS, el-Yousef MK, Davis JM, Sekerke HJ. A cholinergic-adrenergic hypothesis of mania and depression. Lancet. 1972;2:632–5.

    Article  CAS  PubMed  Google Scholar 

  19. Sitaram N, Nurnberger JI, Jr., Gershon ES, Gillin JC. Cholinergic regulation of mood and REM sleep: potential model and marker of vulnerability to affective disorder. Am J Psychiatry. 1982;139:571–6.

    Article  CAS  PubMed  Google Scholar 

  20. Sitaram N, Nurnberger JI, Jr., Gershon ES, Gillin JC. Faster cholinergic REM sleep induction in euthymic patients with primary affective illness. Science. 1980;208:200–2.

    Article  CAS  PubMed  Google Scholar 

  21. Foster FG, Kupfer DJ, Coble P, McPartland RJ. Rapid eye movement sleep density. An objective indicator in severe medical-depressive syndromes. Arch Gen Psychiatry. 1976;33:1119–23.

    Article  CAS  PubMed  Google Scholar 

  22. Hochli D, Riemann D, Zulley J, Berger M. Initial REM sleep suppression by clomipramine: a prognostic tool for treatment response in patients with a major depressive disorder. Biol Psychiatry. 1986;21:1217–20.

    Article  CAS  PubMed  Google Scholar 

  23. Kupfer DJ, Spiker DG, Rossi A, Coble PA, Shaw D, Ulrich R. Nortriptyline and EEG sleep in depressed patients. Biol Psychiatry. 1982;17:535–46.

    CAS  PubMed  Google Scholar 

  24. Wehr TA, Goodwin FK. Biological rhythms in manic-depressive illness. In: Wehr TA, Goodwin FK, editors. Circadian rhythms in psychiatry. Pacific Groove: Boxwood; 1983. pp. 129–84.

    Google Scholar 

  25. Wehr TA, Wirz-Justice A. Circadian rhythm mechanisms in affective illness and in antidepressant drug action. Pharmacopsychiatria. 1982;15:31–9.

    Article  CAS  PubMed  Google Scholar 

  26. Borbely AA. A two process model of sleep regulation. Hum Neurobiol. 1982;1:195–204.

    CAS  PubMed  Google Scholar 

  27. Borbely AA, Wirz-Justice A. Sleep, sleep deprivation and depression. A hypothesis derived from a model of sleep regulation. Hum Neurobiol. 1982;1:205–10.

    CAS  PubMed  Google Scholar 

  28. Frey S, Birchler-Pedross A, Hofstetter M, et al. Young women with major depression live on higher homeostatic sleep pressure than healthy controls. Chronobiol Int. 2012;29:278–94.

    Article  PubMed  Google Scholar 

  29. Hauri P, Hawkins DR. Phasic REM, depression, and the relationship between sleeping and waking. Arch Gen Psychiatry. 1971;25:56–63.

    Article  CAS  PubMed  Google Scholar 

  30. Benedetti F, Colombo C. Sleep deprivation in mood disorders. Neuropsychobiology. 2011;64:141–51.

    Article  PubMed  Google Scholar 

  31. Schulte W. Zum Problem der Provokation und Kupierung von melancholischen Phasen. Schweizer Arch Neurol Neurochem Psychiatr. 1971;109:427–35.

    CAS  Google Scholar 

  32. Pflug B, Tolle R. Therapy of endogenous depressions using sleep deprivation. Practical and theoretical consequences. Nervenarzt. 1971;42:117–24.

    CAS  PubMed  Google Scholar 

  33. Leibenluft E, Wehr TA. Is sleep deprivation useful in the treatment of depression? Am J Psychiatry. 1992;149:159–68.

    Article  CAS  PubMed  Google Scholar 

  34. Wirz-Justice A, Benedetti F, Terman M. Chronotherapeutics for affective disorders. A clinician’s manual for light and wake therapy. Basel: Karger; 2009.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sara Dallaspezia .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Dallaspezia, S., Benedetti, F. (2015). Bipolar Disorder. In: Chokroverty, S., Billiard, M. (eds) Sleep Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2089-1_40

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-2089-1_40

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-2088-4

  • Online ISBN: 978-1-4939-2089-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics