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Sleep and circadian rhythms in children and adolescents with bipolar disorder

Published online by Cambridge University Press:  25 October 2006

ALLISON G. HARVEY
Affiliation:
University of California, Berkeley
BENJAMIN C. MULLIN
Affiliation:
University of California, Berkeley
STEPHEN P. HINSHAW
Affiliation:
University of California, Berkeley

Abstract

The aim of this paper is to highlight the importance of the sleep–wake cycle in children and adolescents with bipolar disorder. After presenting an overview of the measurement and function of human sleep, we describe changes in sleep and circadian functioning across the life cycle. We then review evidence that, in adults, sleep and/or circadian rhythms are of considerable influence in the multifactorial causal chain implicated in relapse in bipolar disorder, discussing relevant mechanisms. The latter include abnormalities in the amount and timing of sleep, the role of social zeitgebers, and the importance of sleep in regulating emotional responses and mood. We next present preliminary data indicating considerable sleep disturbance among children and adolescents with bipolar disorder. Given the considerable sleep disturbance evident among children and adolescents with bipolar disorder along with a key role for sleep in emotion regulation and learning, we conclude that sleep among children and adolescents with bipolar disorder is a critical domain for future research. An agenda for future research is presented that includes descriptive studies, investigations of causality, and treatment development research.

Type
Research Article
Copyright
© 2006 Cambridge University Press

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