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.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Planning Grant (R34)
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Interventions Committee for Adult Mood and Anxiety Disorders (ITMA)
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Muehrer, Peter R
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University of California Berkeley
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United States
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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
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