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Treating insomnia improves mood state, sleep, and functioning in bipolar disorder: a pilot randomized controlled
Allison G Harvey1, Adriane M Soehner1, Kate A Kaplan1
1Department of Psychology, University of California, Berkeley.
Journal of Consulting and Clinical Psychology
|January 27, 2015
Summary
Cognitive behavioral therapy for insomnia adapted for bipolar disorder (CBTI-BP) significantly reduced mood episodes and improved sleep in patients with bipolar disorder I and insomnia. This treatment offers a promising approach for managing bipolar disorder symptoms by targeting sleep disturbances.
Area of Science:
- Psychiatry
- Sleep Medicine
- Behavioral Therapy
Background:
- Insomnia is a common comorbidity in bipolar disorder.
- Sleep disturbances can trigger mood episodes in bipolar disorder.
- Effective treatments for insomnia in bipolar disorder are needed.
Purpose of the Study:
- To evaluate the efficacy of a bipolar disorder-specific cognitive behavioral therapy for insomnia (CBTI-BP) intervention.
- To assess improvements in mood state, sleep quality, and daily functioning in patients with bipolar disorder I and insomnia.
Main Methods:
- A pilot randomized controlled trial comparing CBTI-BP to psychoeducation (PE) in interepisode bipolar disorder I patients with insomnia.
- Participants received 8 sessions of treatment alongside standard psychiatric care.
- Outcomes were measured at baseline, post-treatment, and 6-month follow-up.
Main Results:
- The CBTI-BP group experienced significantly fewer days in bipolar episodes and lower relapse rates for hypomania/mania and overall mood episodes compared to the PE group.
- CBTI-BP significantly reduced insomnia severity and increased insomnia remission rates.
- Both interventions improved sleep and functioning, with sustained effects at follow-up.
Conclusions:
- CBTI-BP is effective in reducing mood episode relapse risk and improving sleep and functioning in bipolar disorder patients.
- Sleep disturbance is a critical factor in the pathophysiology of bipolar disorder.
- Standardized sleep diary scoring for bipolar disorder requires further development.
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