Psychological and behavioural interventions in bipolar disorder that target sleep and circadian rhythms: a systematic review of randomised controlled trials

Sleep and circadian disruptions are prominent symptoms of bipolar disorder (BD) and potential targets for adjunctive interventions. The aim of this review was to appraise the effectiveness of psychological and behavioural interventions in BD that target sleep and circadian rhythms, as reported by ra...

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Main Authors: Bisdounis, L, Saunders, KEA, Farley, HJ, Lee, CK, McGowan, NM, Espie, CA, Kyle, SD
Format: Journal article
Language:English
Published: Elsevier 2021
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author Bisdounis, L
Saunders, KEA
Farley, HJ
Lee, CK
McGowan, NM
Espie, CA
Kyle, SD
author_facet Bisdounis, L
Saunders, KEA
Farley, HJ
Lee, CK
McGowan, NM
Espie, CA
Kyle, SD
author_sort Bisdounis, L
collection OXFORD
description Sleep and circadian disruptions are prominent symptoms of bipolar disorder (BD) and potential targets for adjunctive interventions. The aim of this review was to appraise the effectiveness of psychological and behavioural interventions in BD that target sleep and circadian rhythms, as reported by randomised controlled trials. Nineteen studies met the inclusion/exclusion criteria. They were summarised via narrative synthesis and meta-analysis wherever appropriate. Six studies delivered bright light therapy, five interpersonal and social rhythm therapy, two blue-light blocking glasses, one cognitive behavioural therapy for insomnia, one total sleep deprivation, and four combination treatments. More than half of the studies (N = 10, 52 %) did not measure sleep or circadian rhythms despite being the principal target of the intervention. Overall, the evidence base for the effectiveness of these interventions was limited. There was a small number of studies for each intervention, and a lack of consistency in protocols and outcomes. Meta-analysis was possible for the effect of bright light therapy on depression, revealing a medium-to-large post-treatment effect (Nc = 6; g=-0.74 [95 % CI=-1.05 to -0.42], p < 0.001).
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spelling oxford-uuid:dfdd03e0-3034-42ed-919c-26ba54bcef992022-12-06T09:03:09ZPsychological and behavioural interventions in bipolar disorder that target sleep and circadian rhythms: a systematic review of randomised controlled trialsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:dfdd03e0-3034-42ed-919c-26ba54bcef99EnglishSymplectic ElementsElsevier2021Bisdounis, LSaunders, KEAFarley, HJLee, CKMcGowan, NMEspie, CAKyle, SDSleep and circadian disruptions are prominent symptoms of bipolar disorder (BD) and potential targets for adjunctive interventions. The aim of this review was to appraise the effectiveness of psychological and behavioural interventions in BD that target sleep and circadian rhythms, as reported by randomised controlled trials. Nineteen studies met the inclusion/exclusion criteria. They were summarised via narrative synthesis and meta-analysis wherever appropriate. Six studies delivered bright light therapy, five interpersonal and social rhythm therapy, two blue-light blocking glasses, one cognitive behavioural therapy for insomnia, one total sleep deprivation, and four combination treatments. More than half of the studies (N = 10, 52 %) did not measure sleep or circadian rhythms despite being the principal target of the intervention. Overall, the evidence base for the effectiveness of these interventions was limited. There was a small number of studies for each intervention, and a lack of consistency in protocols and outcomes. Meta-analysis was possible for the effect of bright light therapy on depression, revealing a medium-to-large post-treatment effect (Nc = 6; g=-0.74 [95 % CI=-1.05 to -0.42], p < 0.001).
spellingShingle Bisdounis, L
Saunders, KEA
Farley, HJ
Lee, CK
McGowan, NM
Espie, CA
Kyle, SD
Psychological and behavioural interventions in bipolar disorder that target sleep and circadian rhythms: a systematic review of randomised controlled trials
title Psychological and behavioural interventions in bipolar disorder that target sleep and circadian rhythms: a systematic review of randomised controlled trials
title_full Psychological and behavioural interventions in bipolar disorder that target sleep and circadian rhythms: a systematic review of randomised controlled trials
title_fullStr Psychological and behavioural interventions in bipolar disorder that target sleep and circadian rhythms: a systematic review of randomised controlled trials
title_full_unstemmed Psychological and behavioural interventions in bipolar disorder that target sleep and circadian rhythms: a systematic review of randomised controlled trials
title_short Psychological and behavioural interventions in bipolar disorder that target sleep and circadian rhythms: a systematic review of randomised controlled trials
title_sort psychological and behavioural interventions in bipolar disorder that target sleep and circadian rhythms a systematic review of randomised controlled trials
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