SynthesisBipolar disorders2026
Managing Sleep in Bipolar Disorder: An Overview of Pharmacological and Non-Pharmacological Interventions.
Synthesis in Bipolar disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
8 authors.
Funding
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Abstract
objectivesSleep disturbances are common in individuals with bipolar disorder (BD) and are linked to greater symptom severity, higher relapse risk, and increased suicidality. Despite their clinical relevance, sleep problems in BD are frequently underdiagnosed and inadequately treated. This systematic review aimed to evaluate the efficacy and safety of pharmacological and non-pharmacological interventions specifically targeting sleep disturbances in BD.
methodsWe systematically searched PubMed, Embase, Web of Science, and PsycINFO for studies published until May 2025. Inclusion criteria encompassed randomized controlled trials and observational studies assessing interventions specifically targeting sleep disturbances in individuals with BD.
resultsEleven studies met the inclusion criteria. Non-pharmacological interventions, particularly cognitive behavioral therapy for insomnia adapted for bipolar disorder (CBTI-BD), consistently improved sleep efficiency, latency, and total sleep time and were associated with reductions in depressive symptoms. Bright light therapy yielded mixed results, whereas the Benson Relaxation Technique showed improvements in sleep quality and emotional regulation. Among pharmacological approaches, melatonin improved circadian alignment and sleep parameters without mood destabilization. Suvorexant showed limited efficacy. Antidepressants were linked to poorer sleep quality and greater impulsivity during euthymia.
conclusionsSleep-focused interventions, especially behavioral strategies such as CBTI-BD, appear effective and well tolerated for managing sleep disturbances in BD, primarily in euthymic and interepisode samples where they have been tested. Pharmacological interventions show more variable effects and require careful attention to tolerability and clinical stability. Because each intervention was evaluated in a single clinical phase, the available evidence cannot determine whether clinical phase or chronotype moderates treatment response; trials designed to detect such moderation are needed before individualized, phase-specific recommendations can be made.
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