title: Sleep-related functioning in euthymic patients with bipolar disorder, patients with insomnia, and subjects without sleep problems.
abstract: OBJECTIVE
  The authors investigated sleep-related functioning in euthymic patients with bipolar disorder.
  
  
  METHODS
  Euthymic patients with bipolar disorder (N=20), patients with insomnia (N=20), and subjects with good sleep (N=20) were compared on data from interviews and questionnaires and on findings from eight consecutive days and nights of sleep diary keeping (subjective sleep estimate) and actigraphy (objective sleep estimate).
  
  
  RESULTS
  Seventy percent of the euthymic patients with bipolar disorder exhibited a clinically significant sleep disturbance. Compared with the other groups, the bipolar disorder group exhibited impaired sleep efficiency, higher levels of anxiety and fear about poor sleep, lower daytime activity levels, and a tendency to misperceive sleep. The bipolar disorder group held a level of dysfunctional beliefs about sleep that was comparable to that in the insomnia group and significantly higher than that in the good sleeper group.
  
  
  CONCLUSIONS
  Insomnia is a significant problem among euthymic patients with bipolar disorder. Components of cognitive behavior therapy for insomnia, especially stimulus control and cognitive therapy, may be a helpful adjunct to treatment for patients with bipolar disorder.
authors.affiliation: Department of Experimental Psychology, University of Oxford, UK. aharvey@berkeley.edu
authors.forename: Allison G
authors.initials: AG
authors.lastname: Harvey
authors.forename: D Anne
authors.initials: DA
authors.lastname: Schmidt
authors.forename: Antonina
authors.initials: A
authors.lastname: Scarnà
authors.forename: Christina Neitzert
authors.initials: CN
authors.lastname: Semler
authors.forename: Guy M
authors.initials: GM
authors.lastname: Goodwin
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D010555:Personality Inventory; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012890:Sleep / Q000502:physiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000523:psychology; D011795:Surveys and Questionnaires; D014851:Wakefulness / Q000502:physiology