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Sleep and Circadian Rhythm Abnormalities in the Pathophysiology of Bipolar Disorder

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Behavioral Neurobiology of Bipolar Disorder and its Treatment

Part of the book series: Current Topics in Behavioral Neurosciences ((CTBN,volume 5))

Abstract

Among other factors, bipolar disorder is characterized by disturbances in sleep and biological rhythms that typically cycle over a 24-h, or circadian period. Indeed, almost all of the functions that constitute symptoms of depression and mania (changes in mood, energy, sleep, interest, appetite, capacity for concentration, etc.) show relatively regular variation over the circadian period. Thus, it would appear logical to search for clues to the pathophysiology of bipolar disorder in the function of the circadian timing system (Wirz-Justice in Int Clin Psychopharmacol 21:S11–S15, 2006). In this chapter, we review the known sleep and biological rhythm abnormalities associated with bipolar disorder. We describe the nature of these circadian rhythm abnormalities and review the evidence supporting their role in bipolar episodes. Last, we discuss a number of pharmacologic and psychosocial treatments for bipolar disorder that target sleep and biological rhythm abnormalities, and we examine their effect on bipolar episodes and symptoms.

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Abbreviations

CBT:

Cognitive behavior therapy

CC:

Collaborative care

CSM :

Composite scale of morningness

CT:

Cognitive therapy

DT:

Dark therapy

FFT:

Family-focused therapy

HPA:

Hypothalamic-pituitary-adrenocortical

IPT:

Interpersonal psychotherapy

IPSRT:

Interpersonal and social rhythm therapy

LT:

Light therapy

M/E:

Morningness/eveningness continuum

MTBD:

Maintenance therapies in bipolar disorder

SD:

Sleep deprivation

SRM:

Social rhythm metric

STEP-BD :

Systematic treatment enhancement program in bipolar disorder

SZ:

Schizophrenia

SZA:

Schizoaffective disorder

TAU:

Treatment as usual

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Authors and Affiliations

  1. Western Psychiatric Institute and Clinic, 856 Bellefield Towers, 3811 O’Hara Street, Pittsburgh, PA, 15213, USA

    Jessica Levenson & Ellen Frank

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  1. Jessica Levenson
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  2. Ellen Frank
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Correspondence to Ellen Frank .

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  1. Research & Development, LLC, Johnson & Johnson Pharmaceutical, Trenton-Habourton Road 1125, Titusville, 08560, New Jersey, USA

    Husseini K. Manji

  2. Mark O. Hatfield Clinical Res. Center, Lab. of Molecular Pathophysiology, National Institute of Mental Health, Center Drive 10, Bethesda, 20892, Maryland, USA

    Carlos A. Zarate Jr.

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Levenson, J., Frank, E. (2010). Sleep and Circadian Rhythm Abnormalities in the Pathophysiology of Bipolar Disorder. In: Manji, H., Zarate Jr., C. (eds) Behavioral Neurobiology of Bipolar Disorder and its Treatment. Current Topics in Behavioral Neurosciences, vol 5. Springer, Berlin, Heidelberg. https://doi.org/10.1007/7854_2010_50

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