A review: Circadian Rhythm Dysfunction and Bipolar Disorder

Introduction Circadian rhythm (CR) dysfunction is a prominent feature in bipolar disorder (BD) and sleep disturbances are characteristic, although not essential to the diagnosis. Objectives To review the literature regarding the CR dysfunction and its impact on the onset and clinical course of BD....

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Main Authors: M. Ribeiro, A. Lourenço, M. Lemos, J. Bastos, J.M. Pereira
Format: Article
Language:English
Published: Cambridge University Press 2022-06-01
Series:European Psychiatry
Subjects:
Online Access:https://www.cambridge.org/core/product/identifier/S0924933822010355/type/journal_article
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author M. Ribeiro
A. Lourenço
M. Lemos
J. Bastos
J.M. Pereira
author_facet M. Ribeiro
A. Lourenço
M. Lemos
J. Bastos
J.M. Pereira
author_sort M. Ribeiro
collection DOAJ
description Introduction Circadian rhythm (CR) dysfunction is a prominent feature in bipolar disorder (BD) and sleep disturbances are characteristic, although not essential to the diagnosis. Objectives To review the literature regarding the CR dysfunction and its impact on the onset and clinical course of BD. Methods We conducted a MEDLINE search using bipolar disorder, circadian rhythm and sleep as keywords, selecting studies written in English. Results CR dysfunction is a trait marker of BD. It’s known that during depressive episodes insomnia is present, with difficulty falling asleep/ maintaining sleep and early awakening. Regarding mania, decreased need for sleep is a critical marker. During the euthymic period significant alterations in sleep pattern have been described. It’s also known that changes in the sleep pattern occur prior to those in mood patterns, indicating that sleep dysregulation may trigger the onset of mood episodes or relapses. Therefore, CR disruption may be associated with the pathophysiology of BD and some factors have already been identified: irregularity of the sleep-wake rhythm, eveningness chronotype, abnormality of melatonin secretion, vulnerability of clock genes and the irregularity of social zeitgeber. Conclusions Disturbances of sleep are pervasive, and an essential feature of BD, worse during mood episodes, but still present during euthymic periods. It remains to determine whether circadian rhythm dysfunction is a trait marker or mood state dependent. Further studies are warranted to clarify this association. Disclosure No significant relationships.
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spelling doaj.art-a1547e06af5c491e8025a58e4d17cb222023-11-17T05:06:53ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S408S40810.1192/j.eurpsy.2022.1035A review: Circadian Rhythm Dysfunction and Bipolar DisorderM. Ribeiro0A. Lourenço1M. Lemos2J. Bastos3J.M. Pereira4Centro Hospitalar Lisboa Norte, Psychiatry, Lisboa, PortugalCentro Hospitalar Lisboa Norte, Psychiatry, Lisboa, PortugalCentro Hospitalar Lisboa Norte, Psychiatry, Lisboa, PortugalHospital Prof. Doutor Fernando Fonseca, Departamento De Saúde Mental, Amadora, PortugalCentro Hospitalar Lisboa Norte, Psychiatry, Lisboa, Portugal Introduction Circadian rhythm (CR) dysfunction is a prominent feature in bipolar disorder (BD) and sleep disturbances are characteristic, although not essential to the diagnosis. Objectives To review the literature regarding the CR dysfunction and its impact on the onset and clinical course of BD. Methods We conducted a MEDLINE search using bipolar disorder, circadian rhythm and sleep as keywords, selecting studies written in English. Results CR dysfunction is a trait marker of BD. It’s known that during depressive episodes insomnia is present, with difficulty falling asleep/ maintaining sleep and early awakening. Regarding mania, decreased need for sleep is a critical marker. During the euthymic period significant alterations in sleep pattern have been described. It’s also known that changes in the sleep pattern occur prior to those in mood patterns, indicating that sleep dysregulation may trigger the onset of mood episodes or relapses. Therefore, CR disruption may be associated with the pathophysiology of BD and some factors have already been identified: irregularity of the sleep-wake rhythm, eveningness chronotype, abnormality of melatonin secretion, vulnerability of clock genes and the irregularity of social zeitgeber. Conclusions Disturbances of sleep are pervasive, and an essential feature of BD, worse during mood episodes, but still present during euthymic periods. It remains to determine whether circadian rhythm dysfunction is a trait marker or mood state dependent. Further studies are warranted to clarify this association. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933822010355/type/journal_articlecircadian rhythmbipolar disordersleep
spellingShingle M. Ribeiro
A. Lourenço
M. Lemos
J. Bastos
J.M. Pereira
A review: Circadian Rhythm Dysfunction and Bipolar Disorder
European Psychiatry
circadian rhythm
bipolar disorder
sleep
title A review: Circadian Rhythm Dysfunction and Bipolar Disorder
title_full A review: Circadian Rhythm Dysfunction and Bipolar Disorder
title_fullStr A review: Circadian Rhythm Dysfunction and Bipolar Disorder
title_full_unstemmed A review: Circadian Rhythm Dysfunction and Bipolar Disorder
title_short A review: Circadian Rhythm Dysfunction and Bipolar Disorder
title_sort review circadian rhythm dysfunction and bipolar disorder
topic circadian rhythm
bipolar disorder
sleep
url https://www.cambridge.org/core/product/identifier/S0924933822010355/type/journal_article
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