Bipolar disorder is a severe and chronic disorder, ranked in the top 10 leading causes of disability worldwide. While there have been important advances in treatments, a significant proportion of patients continue to experience disabling symptoms between episodes and the risk of relapse into an episode of depression or mania remains high. Three lines of evidence converge on sleep disturbance as one important mechanism contributing to inter-episode dysfunction and relapse in bipolar disorder: (1) sleep disturbance is a core symptom of bipolar disorder, (2) experimental studies suggest that sleep deprivation can trigger manic relapse and (3) there is evidence that sleep deprivation can undermine emotion regulation the following day. Accordingly, we seek to determine if an intervention to improve sleep can improve treatment outcome for patients with bipolar disorder.
Specific Aims : (1) To develop and refine an intervention to improve the sleep of patients with bipolar disorder. (2) To prepare for a larger scale intervention study by conducting a pilot randomized controlled trial which will establish if a Sleep Intervention can produce durable improvements in sleep and improvements in inter-episode quality of life and emotional functioning in bipolar I patients. Research Plan: Phase 1 involves an iterative process of developing and refining the intervention by testing the treatment with patients diagnosed with bipolar I disorder who also suffer from sleep disturbance (n = 12). In Phase 2, a sample of 48 patients with bipolar I disorder, who also suffer from sleep disturbance, will be randomized to one of two groups: (a) Sleep Intervention or (b) Information Only. Outcome measures will be taken at baseline and the end of treatment for both groups. The Sleep Intervention Group will be reassessed at 6 months post treatment. Long-term objective: To develop a novel non-pharmacological adjunctive intervention, or new components to add to existing interventions, that will improve sleep in bipolar patients, enhance inter-episode quality of life and reduce risk of relapse.

Public Health Relevance

Bipolar disorder is a severe and chronic disorder that is difficult to treat. The sleep disturbance commonly suffered by patients with bipolar disorder reduces their quality of life and contributes to relapse. This study seeks to determine if an intervention to improve sleep can improve treatment outcome for patients with bipolar disorder.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Planning Grant (R34)
Project #
1R34MH080958-01A2
Application #
7739933
Study Section
Interventions Committee for Adult Mood and Anxiety Disorders (ITMA)
Program Officer
Muehrer, Peter R
Project Start
2009-07-01
Project End
2012-03-31
Budget Start
2009-07-01
Budget End
2010-03-31
Support Year
1
Fiscal Year
2009
Total Cost
$257,614
Indirect Cost
Name
University of California Berkeley
Department
Neurosciences
Type
Organized Research Units
DUNS #
124726725
City
Berkeley
State
CA
Country
United States
Zip Code
94704
Dolsen, Michael R; Soehner, Adriane M; Harvey, Allison G (2018) Proinflammatory Cytokines, Mood, and Sleep in Interepisode Bipolar Disorder and Insomnia: A Pilot Study With Implications for Psychosocial Interventions. Psychosom Med 80:87-94
Soehner, A M; Kaplan, K A; Saletin, J M et al. (2018) You'll feel better in the morning: slow wave activity and overnight mood regulation in interepisode bipolar disorder. Psychol Med 48:249-260
Kanady, Jennifer C; Soehner, Adriane M; Klein, Alexandra B et al. (2017) The association between insomnia-related sleep disruptions and cognitive dysfunction during the inter-episode phase of bipolar disorder. J Psychiatr Res 88:80-88
Gershon, Anda; Ram, Nilam; Johnson, Sheri L et al. (2016) Daily Actigraphy Profiles Distinguish Depressive and Interepisode States in Bipolar Disorder. Clin Psychol Sci 4:641-650
Harvey, Allison G; Kaplan, Katherine A; Soehner, Adriane M (2015) Interventions for Sleep Disturbance in Bipolar Disorder. Sleep Med Clin 10:101-5
Kanady, Jennifer C; Soehnera, Adriane M; Harvey, Allison G (2015) A Retrospective Examination of Sleep Disturbance across the Course of Bipolar Disorder. J Sleep Disord Ther 4:
Harvey, Allison G; Soehner, Adriane M; Kaplan, Kate A et al. (2015) Treating insomnia improves mood state, sleep, and functioning in bipolar disorder: a pilot randomized controlled trial. J Consult Clin Psychol 83:564-77
Kaplan, K A; McGlinchey, E L; Soehner, A et al. (2015) Hypersomnia subtypes, sleep and relapse in bipolar disorder. Psychol Med 45:1751-63
Lee, Jason Y; Harvey, Allison G (2015) Memory for therapy in bipolar disorder and comorbid insomnia. J Consult Clin Psychol 83:92-102
McGlinchey, Eleanor L; Gershon, Anda; Eidelman, Polina et al. (2014) Physical activity and sleep: Day-to-day associations among individuals with and without Bipolar Disorder. Ment Health Phys Act 7:183-190

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