Bipolar disorder and sleep problems

BACKGROUND: Sleep problems are highly prevalent among patients with bipolar disorder and have a substantial impact on the course of illness. METHOD: We conducted a series of literature searches using as key words or as items in indexed fields, bipolar disorder and sleep problems. Articles were obtained by searching MEDLINE from 1970 to 2012. In addition, we used other papers cited in articles from these searches, or cited in articles used in our own work. RESULTS: Disturbance of the sleep/wake cycle has been a core component of bipolar disorder. Reduced total sleep time is a predictor of manic episodes Sleep is disturbed during manic episodes as well as during inter-episode period. Treatment of sleep disturbance in bipolar relies on pharmacotherapy, sleep deprivation with or without light therapy, and psychological treatments. CONCLUSION: Multiple lines of evidence suggest that sleep disruption may be an underlying trigger for manic and depressive episodes that sleep improvement may be a clinically useful therapeutic target, and that successful prevention of relapse may rely in part on maintaining adequate sleep.