Treatment of a Rapidly Cycling Bipolar Patient by Using Extended Bed Rest and Darkness to Stabilize the Timing and Duration of Sleep

Wehr, Thomas A.; Turner, Erick H.; Shimada, Jeffrey M.; Lowe, Catherine H.; Barker, Charles; Leibenluft, Ellen

doi:10.1016/s0006-3223(97)00542-8

Cited by 146 publications

(90 citation statements)

References 16 publications

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“…Studies in rapid cycling bipolar disorder indicate that the timing of the melatonin peak is vital with morning, but not noon light tending to induce hypomania in some patients (Kripke, 1991;Leibenluft et al, 1995). Two groups have recently demonstrated that lengthened sleep periods and enforced darkness ameliorate the symptoms of rapid cycling bipolar disorder (Wehr et al, 1998;WirzJustice et al, 1999). We propose that lithium and valproate may share a common mechanism of action in decreasing melatonin sensitivity to light, leading long-term to the normalization of the circadian phase advance that has been observed in patients with bipolar disorder.…”

Section: Discussionmentioning

confidence: 99%

Effect of Sodium Valproate on Nocturnal Melatonin Sensitivity to Light in Healthy Volunteers

Hallam

Olver

Norman

2005

Neuropsychopharmacol

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Section: Discussionmentioning

confidence: 99%

Effect of Sodium Valproate on Nocturnal Melatonin Sensitivity to Light in Healthy Volunteers

Hallam

Olver

Norman

2005

Neuropsychopharmacol

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“…According to some studies, this switch risk might be higher for antidepressants, which are particularly sedating [102][103][104][105] . In contrast, stabilization of the sleep-wake rhythm is an established part in behavioural therapies for bipolar disorder [106][107][108] , and extended bed rest is used as an add-on in the treatment of acute mania [109][110][111] . Furthermore, case reports show acute antimanic effects of psychostimulants [reviewed in 112 ].…”

Section: The Vigilance Regulation Model Of Affective Disorders and Adhdmentioning

confidence: 99%

Assessment of Wakefulness and Brain Arousal Regulation in Psychiatric Research

Sander¹,

Hensch²,

Wittekind³

et al. 2015

Neuropsychobiology

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tion of wakefulness to the environmental and situational needs so that the optimal balance between energy conservation and responsiveness can be obtained. Since one approach to the assessment of brain arousal regulation is the classification of EEG vigilance stages, a computer-based algorithm (Vigilance Algorithm Leipzig) has been introduced, allowing classification of EEG vigilance stages in EEG recordings under resting conditions. The time course of EEG vigilance stages in EEGs of 15-20 min duration allows estimation of the individual arousal regulation (hyperstable, adaptive, or unstable vigilance pattern). The vigilance model of affective disorders and attention-deficit/hyperactivity disorder links a disturbed arousal regulation to the pathogenesis of psychiatric disorders and accordingly helps to explain and possibly also predict treatment effects of pharmacological and nonpharmacological interventions for these conditions. AbstractDuring the last few decades, much knowledge has been gained about sleep being a heterogeneous condition with several distinct sleep stages that represent fundamentally different physiological states. The same applies for the wake state which also comprises distinct global functional states (called vigilance stages). However, various terms and concepts have been introduced describing different aspects of wakefulness, and accordingly several methods of assessment exist, e.g. sleep laboratory assessments (Multiple Sleep Latency Test, Maintenance of Wakefulness Test), questionnaires (Epworth Sleepiness Scale, Karolinska Sleepiness Scale), behavioural tasks (Psychomotor Vigilance Test) or electroencephalography (EEG)-based assessments (Alpha Attenuation Test, Karolinska Drowsiness Test). Furthermore, several theoretical concepts about the regulation of sleep and wakefulness have been put forward, and physiological correlates have been identified. Most relevant for healthy functioning is the regulation of brain arousal and the adap-

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“…Case studies suggest that increasing sleep duration may help prevent symptoms of bipolar disorder (cf. Wehr et al, 1998).…”

Section: Schedule-disrupting Life Eventsmentioning

confidence: 99%

Life events in bipolar disorder: Towards more specific models

Johnson

2005

Clinical Psychology Review

180

167

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This article reviews the evidence concerning life events as a predictor of symptoms within bipolar disorder. First, key methodological issues in this area are described, and criteria used for including studies in this review are defined. Then findings that negative life events predict worse outcomes within bipolar disorder are reviewed. Beyond general studies on relapse, it is important to differentiate predictors of depression from predictors of mania. When severe negative life events occur, they appear to trigger increases in bipolar depression. Nonetheless, many depressions are unrelated to negative life events and appear to be triggered by other variables. The strongest evidence suggests that negative life events do not trigger mania, except perhaps in certain contexts. Retrospective findings for schedule-disrupting life events as a trigger for manic symptoms await further assessment within a longitudinal study. Life events involving goal attainment do appear to trigger manic symptoms. Overall, it is time to differentiate among specific types of life events, as these different forms of events point towards mechanisms linking stressors with symptom expression. These mechanisms provide clues into ways to integrate the social environment with biological vulnerability (see Bipolar disorder is clearly a biological disorder. Nonetheless, over the past 15 years, a wealth of research has made it abundantly clear that psychosocial variables shape outcomes of this disorder. Much of this psychosocial research has focused on whether life events predict the timing and severity of symptoms within this disorder. This paper reviews the evidence that life events are related to symptom expression within bipolar disorder. This basic question has challenged researchers for over 20 years. Given the growing literature, this paper focus on addressing two more specific questions. Which types of symptoms are related to life events? What types of life events influence symptoms? Given the growing number of studies available on these issues, this review will focus on those studies with the most rigorous methodologies. To set the stage for this endeavor, it is important to first review the major methodological issues in research on life events and bipolar disorder, including issues related to design, measurement, and sampling.

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Treatment of a Rapidly Cycling Bipolar Patient by Using Extended Bed Rest and Darkness to Stabilize the Timing and Duration of Sleep

Cited by 146 publications

References 16 publications

Effect of Sodium Valproate on Nocturnal Melatonin Sensitivity to Light in Healthy Volunteers

Effect of Sodium Valproate on Nocturnal Melatonin Sensitivity to Light in Healthy Volunteers

Assessment of Wakefulness and Brain Arousal Regulation in Psychiatric Research

Life events in bipolar disorder: Towards more specific models

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