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Sleep and Circadian Rhythm Disorder in Bipolar Affective Disorder

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Bipolar Disorder: From Neuroscience to Treatment

Part of the book series: Current Topics in Behavioral Neurosciences ((CTBN,volume 48))

Abstract

Symptoms of affective disorders encompass a range of changes to biological processes such as sleep and appetite. These processes are regulated over a 24-h cycle known as the circadian rhythm. Sleep is a particularly useful marker of this rhythm as it is readily measurable and functionally significant. Sleep disturbance is common in bipolar affective disorder and may act as a marker, and precipitant, of relapse. Circadian rhythms are modulated by environmental and social cues and have been shown to be influenced by treatment in BPAD. As such understanding of circadian rhythms may lead to a better understanding of the pathophysiology of BPAD and its treatment. This chapter will explore the neurobiology of the circadian clock and the putative role of circadian rhythm dysregulation in the pathophysiology and treatment of bipolar affective disorder (BPAD).

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References

  • Alloy LB, Nusslock R, Boland EM (2015) The development and course of bipolar spectrum disorders: an integrated reward and circadian rhythm dysregulation model. Annu Rev Clin Psychol 11:213–250

    PubMed  PubMed Central  Google Scholar 

  • Anderson KN (2018) Circadian rhythm sleep disorders. In: Sleep disorders in neurology. Wiley, Hoboken, pp 169–181. https://onlinelibrary.wiley.com/doi/abs/10.1002/9781118777251.ch11

    Google Scholar 

  • Auger RR, Burgess HJ, Emens JS, Deriy LV, Thomas SM, Sharkey KM (2015) Clinical practice guideline for the treatment of intrinsic circadian rhythm sleep-wake disorders: advanced sleep-wake phase disorder (ASWPD), delayed sleep-wake phase disorder (DSWPD), Non-24-hour sleep-wake rhythm disorder (N24SWD), and irregular sleep-W. J Clin sleep Med JCSM Off Publ Am Acad Sleep Med 11(10):1199–1236

    Google Scholar 

  • Baek JH, Kim JS, Kim MJ, Ryu S, Lee K, Ha K et al (2016) Lifetime characteristics of evening-preference and irregular bed-rise time are associated with lifetime seasonal variation of mood and behavior: comparison between individuals with bipolar disorder and healthy controls. Behav Sleep Med 14(2):155–168

    PubMed  Google Scholar 

  • Barbini B, Benedetti F, Colombo C, Dotoli D, Bernasconi A, Cigala-Fulgosi M et al (2005) Dark therapy for mania: a pilot study. Bipolar Disord 7(1):98–101

    PubMed  Google Scholar 

  • Bellivier F, Geoffroy P-A, Etain B, Scott J (2015) Sleep- and circadian rhythm-associated pathways as therapeutic targets in bipolar disorder. Expert Opin Ther Targets 19(6):747–763

    Google Scholar 

  • Benedetti F (2018) Rate of switch from bipolar depression into mania after morning light therapy: a historical review. Psychiatry Res 261:351–356

    PubMed  Google Scholar 

  • Benedetti F, Serretti A, Colombo C, Barbini B, Lorenzi C, Campori E et al (2003 Nov) Influence of CLOCK gene polymorphism on circadian mood fluctuation and illness recurrence in bipolar depression. Am J Med Genet B Neuropsychiatr Genet 123B(1):23–26

    PubMed  Google Scholar 

  • Benedetti F, Dallaspezia S, Colombo C, Pirovano A, Marino E, Smeraldi E (2008 Nov) A length polymorphism in the circadian clock gene Per3 influences age at onset of bipolar disorder. Neurosci Lett 445(2):184–187

    CAS  PubMed  Google Scholar 

  • Bengesser SA, Reininghaus EZ, Lackner N, Birner A, Fellendorf FT, Platzer M et al (2016) Is the molecular clock ticking differently in bipolar disorder? Methylation analysis of the clock gene ARNTL. World J Biol Psychiatry:1–9

    Google Scholar 

  • Bradley AJ, Webb-Mitchell R, Hazu A, Slater N, Middleton B, Gallagher P et al (2017) Sleep and circadian rhythm disturbance in bipolar disorder. Psychol Med 47(9)

    Google Scholar 

  • Brasil Rocha PM, Campos SB, Neves FS, da Silva Filho HC (2017) Genetic association of the PERIOD3 (Per3) clock gene with bipolar disorder. Psychiatry Investig 14(5):674–680

    PubMed  PubMed Central  Google Scholar 

  • Bumb JM, Enning F, Mueller JK, van der List T, Rohleder C, Findeisen P et al (2016) Differential melatonin alterations in cerebrospinal fluid and serum of patients with major depressive disorder and bipolar disorder. Compr Psychiatry 68:34–39

    CAS  PubMed  Google Scholar 

  • Czeisler CA, Duffy JF, Shanahan TL, Brown EN, Mitchell JF, Rimmer DW et al (1999 Jun) Stability, precision, and near-24-hour period of the human circadian pacemaker. Science 284(5423):2177–2181

    CAS  PubMed  Google Scholar 

  • Darien I (2014) International classification of sleep disorders, 3rd edn. American Academy of Sleep Medicine, Darien

    Google Scholar 

  • Dibner C, Schibler U, Albrecht U (2010) The mammalian circadian timing system: organization and coordination of central and peripheral clocks. Annu Rev Physiol 72:517–549

    CAS  PubMed  Google Scholar 

  • Ehlers CL, Frank E, Kupfer DJ (1988) Social zeitgebers and biological rhythms. A unified approach to understanding the etiology of depression. Arch Gen Psychiatry 45(10):948–952

    CAS  PubMed  Google Scholar 

  • Francesca B (1983) Circadian rhythms of hormones in primary affective disorders. Cephalalgia 3(Suppl 1):105–110

    PubMed  Google Scholar 

  • Frank E, Swartz HA, Kupfer DJ (2000 Sep) Interpersonal and social rhythm therapy: managing the chaos of bipolar disorder. Biol Psychiatry 48(6):593–604

    CAS  PubMed  Google Scholar 

  • Frank E, Kupfer DJ, Thase ME, Mallinger AG, Swartz HA, Fagiolini AM et al (2005 Sep) Two-year outcomes for interpersonal and social rhythm therapy in individuals with bipolar I disorder. Arch Gen Psychiatry 62(9):996–1004

    PubMed  Google Scholar 

  • Geoffroy PA, El Abbassi EMB, Maruani J, Etain B, Lejoyeux M, Amad A et al (2018) Bright light therapy in the morning or at mid-day in the treatment of non-seasonal bipolar depressive episodes (LuBi): study protocol for a dose research phase I / II trial. Psychiatry Investig 15(12):1188–1202

    CAS  PubMed  PubMed Central  Google Scholar 

  • Gershon A, Kaufmann CN, Depp CA, Miller S, Do D, Zeitzer JM et al (2018) Subjective versus objective evening chronotypes in bipolar disorder. J Affect Disord 225:342

    PubMed  Google Scholar 

  • Giglio LMF, da Magalhaes PVS, Andreazza AC, Walz JC, Jakobson L, Rucci P et al (2009) Development and use of a biological rhythm interview. J Affect Disord 118(1–3):161–165

    PubMed  Google Scholar 

  • Golden RN, Gaynes BN, Ekstrom RD, Hamer RM, Jacobsen FM, Suppes T et al (2005) The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence. Am J Psychiatry 162(4):656–662

    PubMed  Google Scholar 

  • Goldstein TR, Merranko J, Krantz M, Garcia M, Franzen P, Levenson J et al (2018) Early intervention for adolescents at-risk for bipolar disorder: a pilot randomized trial of interpersonal and social rhythm therapy (IPSRT). J Affect Disord 235:348–356

    PubMed  PubMed Central  Google Scholar 

  • Goodwin GM, Haddad PM, Ferrier IN, Aronson JK, Barnes T, Cipriani A et al (2016) Evidence-based guidelines for treating bipolar disorder: revised third edition recommendations from the British Association for Psychopharmacology. J Psychopharmacol 30(6):495–553

    CAS  PubMed  PubMed Central  Google Scholar 

  • Gottlieb JF, Benedetti F, Geoffroy PA, Henriksen TEG, Lam RW, Murray G et al (2019) The chronotherapeutic treatment of bipolar disorders: a systematic review and practice recommendations from the ISBD task force on chronotherapy and chronobiology. Bipolar Disord

    Google Scholar 

  • Grandin LD, Alloy LB, Abramson LY (2006 Oct) The social zeitgeber theory, circadian rhythms, and mood disorders: review and evaluation. Clin Psychol Rev 26(6):679–694

    PubMed  Google Scholar 

  • Harvey AG, Soehner AM, Kaplan KA, Hein K, Lee J, Kanady J et al (2015) Treating insomnia improves mood state, sleep, and functioning in bipolar disorder: a pilot randomized controlled trial. J Consult Clin Psychol 83(3):564–577

    PubMed  PubMed Central  Google Scholar 

  • Henriksen TE, Skrede S, Fasmer OB, Schoeyen H, Leskauskaite I, Bjorke-Bertheussen J et al (2016) Blue-blocking glasses as additive treatment for mania: a randomized placebo-controlled trial. Bipolar Disord 18(3):221–232

    PubMed  PubMed Central  Google Scholar 

  • Hoberg AA, Ponto J, Nelson PJ, Frye MA (2013) Group interpersonal and social rhythm therapy for bipolar depression. Perspect Psychiatr Care 49(4):226–234

    PubMed  PubMed Central  Google Scholar 

  • Iitaka C, Miyazaki K, Akaike T, Ishida N (2005) A role for glycogen synthase kinase-3beta in the mammalian circadian clock. J Biol Chem 280(33):29397–29402

    CAS  PubMed  Google Scholar 

  • Inder ML, Crowe MT, Luty SE, Carter JD, Moor S, Frampton CM et al (2015) Randomized, controlled trial of interpersonal and social rhythm therapy for young people with bipolar disorder. Bipolar Disord 17(2):128–138

    PubMed  Google Scholar 

  • Jackson A, Cavanagh J, Scott J (2003 May) A systematic review of manic and depressive prodromes. J Affect Disord 74(3):209–217

    PubMed  Google Scholar 

  • Jankowski KS, Dmitrzak-Weglarz M (2017) ARNTL, CLOCK and PER3 polymorphisms - links with chronotype and affective dimensions. Chronobiol Int 34(8):1105–1113

    CAS  PubMed  Google Scholar 

  • Judd LL, Akiskal HS, Schettler PJ, Endicott J, Maser J, Solomon DA et al (2017) The long-term natural history of the weekly symptomatic status of bipolar I disorder. https://doi.org/10.1001/archpsyc.59.6.530

  • Kang T-H, Reardon JT, Kemp M, Sancar A (2009) Circadian oscillation of nucleotide excision repair in mammalian brain. Proc Natl Acad Sci U S A 106(8):2864–2867

    CAS  PubMed  PubMed Central  Google Scholar 

  • Karthikeyan R, Marimuthu G, Ramasubramanian C, Arunachal G, BaHammam AS, Spence DW et al (2014) Association of Per3 length polymorphism with bipolar I disorder and schizophrenia. Neuropsychiatr Dis Treat 10:2325–2330

    PubMed  PubMed Central  Google Scholar 

  • Krystal AD, Prather AA, Ashbrook LH (2019) The assessment and management of insomnia: an update. World Psychiatry 18(3):337–352

    PubMed  PubMed Central  Google Scholar 

  • Lewy AJ, Sack RL (1989) The dim light melatonin onset as a marker for circadian phase position. Chronobiol Int 6(1):93–102

    CAS  PubMed  Google Scholar 

  • Maruani J, Geoffroy PA (2019) Bright light as a personalized precision treatment of mood disorders. Front Psych 10:85

    Google Scholar 

  • McCarthy MJ (2018) Missing a beat: assessment of circadian rhythm abnormalities in bipolar disorder in the genomic era. Psychiatr Genet

    Google Scholar 

  • McCarthy MJ, Wei H, Nievergelt CM, Stautland A, Maihofer AX, Welsh DK et al (2019) Chronotype and cellular circadian rhythms predict the clinical response to lithium maintenance treatment in patients with bipolar disorder. Neuropsychopharmacology 44(3):620–628

    CAS  PubMed  Google Scholar 

  • McClung CA (2007) Role for the clock gene in bipolar disorder. Cold Spring Harb Symp Quant Biol 72:637–644

    CAS  PubMed  Google Scholar 

  • Melo MC, Garcia RF, de Araujo CF, Luz JH, de Bruin PF, de Bruin VM (2019) Chronotype in bipolar disorder: an 18-month prospective study. Rev Bras Psiquiatr

    Google Scholar 

  • Miklowitz DJ, Otto MW, Frank E, Reilly-Harrington NA, Wisniewski SR, Kogan JN et al (2007) Psychosocial treatments for bipolar depression: a 1-year randomized trial from the systematic treatment enhancement program. Arch Gen Psychiatry 64(4):419–426

    PubMed  PubMed Central  Google Scholar 

  • Moon J-H, Cho C-H, Son GH, Geum D, Chung S, Kim H et al (2016 Sep) Advanced circadian phase in mania and delayed circadian phase in mixed mania and depression returned to normal after treatment of bipolar disorder. EBioMedicine 11:285–295

    PubMed  PubMed Central  Google Scholar 

  • Mukherjee S, Coque L, Cao J-L, Kumar J, Chakravarty S, Asaithamby A et al (2010 Sep) Knockdown of clock in the ventral tegmental area through RNA interference results in a mixed state of mania and depression-like behavior. Biol Psychiatry 68(6):503–511

    CAS  PubMed  PubMed Central  Google Scholar 

  • Ng TH, Chung K-F, Lee C-T, Yeung W-F, Ho FYY (2016) Eveningness and its associated impairments in remitted bipolar disorder. Behav Sleep Med 14(6):650–664

    PubMed  Google Scholar 

  • Novakova M, Prasko J, Latalova K, Sladek M, Sumova A (2015) The circadian system of patients with bipolar disorder differs in episodes of mania and depression. Bipolar Disord 17(3):303–314

    CAS  PubMed  Google Scholar 

  • Nurnberger JIJ, Adkins S, Lahiri DK, Mayeda A, Hu K, Lewy A et al (2000) Melatonin suppression by light in euthymic bipolar and unipolar patients. Arch Gen Psychiatry 57(6):572–579

    CAS  PubMed  Google Scholar 

  • Patke A, Murphy PJ, Onat OE, Krieger AC, Özçelik T, Campbell SS et al (2017) Mutation of the human circadian clock gene CRY1 in familial delayed sleep phase disorder. Cell 169(2):203–215.e13. http://www.sciencedirect.com/science/article/pii/S009286741730346X

    CAS  PubMed  PubMed Central  Google Scholar 

  • Pawlak J, Dmitrzak-Weglarz M, Maciukiewicz M, Wilkosc M, Leszczynska-Rodziewicz A, Zaremba D et al (2015 Apr) Suicidal behavior in the context of disrupted rhythmicity in bipolar disorder--data from an association study of suicide attempts with clock genes. Psychiatry Res 226(2–3):517–520

    PubMed  Google Scholar 

  • Pawlak J, Szczepankiewicz A, Kapelski P, Rajewska-Rager A, Slopien A, Skibinska M et al (2017 Nov) Suicidal behavior in the context of disrupted rhythmicity in bipolar disorder-complementary research of clock genes with suicide risks factors and course of disease. Psychiatry Res 257:446–449

    PubMed  Google Scholar 

  • Randler C, Engelke J (2019) Gender differences in chronotype diminish with age: a meta-analysis based on morningness/chronotype questionnaires. Chronobiol Int 36(7):888–905

    PubMed  Google Scholar 

  • Randler C, Freyth-Weber K, Rahafar A, Florez Jurado A, Kriegs JO (2016) Morningness-eveningness in a large sample of German adolescents and adults. Heliyon 2(11):e00200

    PubMed  PubMed Central  Google Scholar 

  • Reppert SM, Weaver DR (2001) Molecular analysis of mammalian circadian rhythms. Annu Rev Physiol 63:647–676

    CAS  PubMed  Google Scholar 

  • Robillard R, Naismith SL, Rogers NL, Scott EM, Ip TKC, Hermens DF et al (2013) Sleep-wake cycle and melatonin rhythms in adolescents and young adults with mood disorders: comparison of unipolar and bipolar phenotypes. Eur Psychiatry 28(7):412–416

    CAS  PubMed  Google Scholar 

  • Roybal K, Theobold D, Graham A, DiNieri JA, Russo SJ, Krishnan V et al (2007) Mania-like behavior induced by disruption of CLOCK. Proc Natl Acad Sci U S A 104(15):6406–6411

    CAS  PubMed  PubMed Central  Google Scholar 

  • Schnell A, Albrecht U, Sandrelli F (2014) Rhythm and mood: relationships between the circadian clock and mood-related behavior. Behav Neurosci 128(3):326–343

    CAS  PubMed  Google Scholar 

  • Schroeder AM, Colwell CS (2013) How to fix a broken clock. Trends Pharmacol Sci 34(11):605–619

    CAS  PubMed  Google Scholar 

  • Seleem MA, Merranko JA, Goldstein TR, Goldstein BI, Axelson DA, Brent DA et al (2015) The longitudinal course of sleep timing and circadian preferences in adults with bipolar disorder. Bipolar Disord 17(4):392–402

    PubMed  Google Scholar 

  • Serretti A, Benedetti F, Mandelli L, Lorenzi C, Pirovano A, Colombo C et al (2003) Genetic dissection of psychopathological symptoms: insomnia in mood disorders and CLOCK gene polymorphism. Am J Med Genet B Neuropsychiatr Genet 121B(1):35–38

    PubMed  Google Scholar 

  • Shen GHC, Alloy LB, Abramson LY, Sylvia LG (2008) Social rhythm regularity and the onset of affective episodes in bipolar spectrum individuals. Bipolar Disord 10(4):520–529

    PubMed  PubMed Central  Google Scholar 

  • Steardo LJ, de Filippis R, Carbone EA, Segura-Garcia C, Verkhratsky A, De Fazio P (2019) Sleep disturbance in bipolar disorder: neuroglia and circadian rhythms. Front Psych 10:501

    Google Scholar 

  • Swartz HA, Rucci P, Thase ME, Wallace M, Carretta E, Celedonia KL et al (2018) Psychotherapy alone and combined with medication as treatments for bipolar ii depression: a randomized controlled trial. J Clin Psychiatry 79(2)

    Google Scholar 

  • Takaesu Y, Inoue Y, Murakoshi A, Komada Y, Otsuka A, Futenma K et al (2016) Prevalence of circadian rhythm sleep-wake disorders and associated factors in euthymic patients with bipolar disorder. PLoS One 11(7):e0159578

    PubMed  PubMed Central  Google Scholar 

  • Takaesu Y, Inoue Y, Ono K, Murakoshi A, Futenma K, Komada Y et al (2017) Circadian rhythm sleep-wake disorders as predictors for bipolar disorder in patients with remitted mood disorders. J Affect Disord 220:57–61

    PubMed  Google Scholar 

  • Takaesu Y, Inoue Y, Ono K, Murakoshi A, Futenma K, Komada Y et al (2018) Circadian rhythm sleep-wake disorders predict shorter time to relapse of mood episodes in euthymic patients with bipolar disorder: a prospective 48-week study. J Clin Psychiatry 79(1)

    Google Scholar 

  • Talih F, Gebara NY, Andary FS, Mondello S, Kobeissy F, Ferri R (2018 Oct) Delayed sleep phase syndrome and bipolar disorder: pathogenesis and available common biomarkers. Sleep Med Rev 41:133–140

    PubMed  Google Scholar 

  • Tordjman S, Chokron S, Delorme R, Charrier A, Bellissant E, Jaafari N et al (2017) Melatonin: pharmacology, functions and therapeutic benefits. Curr Neuropharmacol 15(3):434–443

    CAS  PubMed  PubMed Central  Google Scholar 

  • Tseng P-T, Chen Y-W, Tu K-Y, Chung W, Wang H-Y, Wu C-K et al (2016) Light therapy in the treatment of patients with bipolar depression: a meta-analytic study. Eur Neuropsychopharmacol 26(6):1037–1047

    CAS  PubMed  Google Scholar 

  • Watson S, Gallagher P, Ritchie JC, Ferrier IN, Young AH (2004) Hypothalamic-pituitary-adrenal axis function in patients with bipolar disorder. Br J Psychiatry 184:496–502

    PubMed  Google Scholar 

  • Wehr TA, Wirz-Justice A, Goodwin FK, Duncan W, Gillin JC (1979) Phase advance of the circadian sleep-wake cycle as an antidepressant. Science 206(4419):710–713

    CAS  PubMed  Google Scholar 

  • Wehr TA, Turner EH, Shimada JM, Lowe CH, Barker C, Leibenluft E (1998) Treatment of rapidly cycling bipolar patient by using extended bed rest and darkness to stabilize the timing and duration of sleep. Biol Psychiatry 43(11):822–828

    CAS  PubMed  Google Scholar 

  • Wirz-Justice A, Quinto C, Cajochen C, Werth E, Hock C (1999) A rapid-cycling bipolar patient treated with long nights, bedrest, and light. Biol Psychiatry 45(8):1075–1077

    CAS  PubMed  Google Scholar 

  • World Health Organization (WHO). 1993. The ICD-10 Classification of Mental and Behavioural Disorders. Genève, Switzerland: World Health Organization.

    Google Scholar 

  • Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Bond DJ, Frey BN et al (2018) Canadian network for mood and anxiety treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord 20(2):97–170

    PubMed  PubMed Central  Google Scholar 

  • Yoshikawa T, Honma S (2016) Lithium lengthens circadian period of cultured brain slices in area specific manner. Behav Brain Res 314:30–37

    CAS  PubMed  Google Scholar 

  • Zhang L, Hirano A, Hsu PK, Jones CR, Sakai N, Okuro M et al (2016) A PERIOD3 variant causes a circadian phenotype and is associated with a seasonal mood trait. Proc Natl Acad Sci U S A 113(11):E1536–E1544. http://www.pnas.org/content/113/11/E1536.abstract

    CAS  PubMed  PubMed Central  Google Scholar 

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Ahmad, A., Anderson, K.N., Watson, S. (2020). Sleep and Circadian Rhythm Disorder in Bipolar Affective Disorder. In: Young, A.H., Juruena, M.F. (eds) Bipolar Disorder: From Neuroscience to Treatment. Current Topics in Behavioral Neurosciences, vol 48. Springer, Cham. https://doi.org/10.1007/7854_2020_150

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