title: Circadian rhythms and sleep in bipolar disorder: implications for pathophysiology and treatment.
abstract: OBJECTIVE
  Multiple lines of evidence support the conceptualization of bipolar disorder as a disorder of circadian rhythms. Considering bipolar disorder in the framework of circadian disturbances also helps understand the clinical phenomenology pointing toward a multisystemic involvement.
  
  
  RESULTS
  Patients with bipolar disorder show altered rhythmicity in body temperature and melatonin rhythms, high day-to-day variability in activity and sleep timing, persistent disturbances of sleep or wake cycles, including disturbances of sleep continuity. The internal clocks are, indeed, responsible for regulating a variety of physiologic functions, including appetitive behaviors, cognitive functions and metabolism.
  
  
  CONCLUSIONS
  An underlying circadian pathology in bipolar disorder is a unifying explicatory model for the high psychiatric and medical comorbidity observed during the long-term course of the disorder. This model also provides a rationale for therapeutic interventions aimed at re-entraining the internal clock.
authors.affiliation: Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Isabella
authors.initials: I
authors.lastname: Soreca
mesh_terms: D001714:Bipolar Disorder / Q000503:physiopathology*; D002940:Circadian Rhythm / Q000502:physiology*; D006801:Humans; D008550:Melatonin / Q000378:metabolism; D012890:Sleep / Q000502:physiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000503:physiopathology
chemical_list: D008550:Melatonin