Chronotype and circadian rhythm in bipolar disorder: A systematic review

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#bipolar-disorder #chronobiology-disorders #circadian-rhythm #depression #humans

Chronotype and circadian rhythm in bipolar disorder: A systematic review

Melo et al., 2017 | Sleep Med Rev | Systematic Review

Citation

Melo Matias C A, Abreu Rafael L C, ... de Bruin Veralice M S. Chronotype and circadian rhythm in bipolar disorder: A systematic review. Sleep Med Rev. 2017-Aug;34:46-58. doi:10.1016/j.smrv.2016.06.007

Abstract

Despite a complex relationship between mood, sleep and rhythm, the impact of circadian disruptions on bipolar disorder (BD) has not been clarified. The purpose of this systematic review was to define current evidence regarding chronotype and circadian rhythm patterns in BD patients. 42 studies were included, involving 3432 BD patients. Disruption of the biological rhythm was identified, even in drug-naïve BD patients and independently of mood status. Daily profiles of melatonin levels and cortisol indicated a delayed phase. Depression was more frequently associated with circadian alterations than euthymia. Few studies evaluated mania, demonstrating irregular rhythms. Evening type was more common in BD adults. Studies about the influence of chronotype on depressive symptoms showed conflicting results. Only one investigation observed the influences of chronotype in mania, revealing no significant association. Effects of psychoeducation and lithium on rhythm in BD patients were poorly studied, demonstrating no improvement of rhythm parameters. Studies about genetics are incipient. In conclusion, disruption in circadian rhythm and eveningness are common in BD. Prospective research evaluating the impact of circadian disruption on mood symptoms, metabolism, seasonality, the influence of age and the effects of mood stabilizers are needed.

Key Findings

Prospective research evaluating the impact of circadian disruption on mood symptoms, metabolism, seasonality, the influence of age and the effects of mood stabilizers are needed.

Outcomes Measured

  • depression
  • cortisol levels

Population

Field Value
Population See abstract
Sample Size 42
Age Range See abstract
Condition sleep

MeSH Terms

  • Bipolar Disorder
  • Chronobiology Disorders
  • Circadian Rhythm
  • Depression
  • Humans
  • Hydrocortisone
  • Melatonin
  • Sleep

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review
  • Vertical: melatonin

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09