This review considers evidence that sleep and circadian rhythms are disturbed in bipolar patients during both
mood episodes and periods of remission. Indeed, bipolar patients display disturbances of subjective and objective
circadian markers, in sleep continuity, and in cortisol and melatonin secretion. Better characterization of sleep and
circadian rhythms can improve personalized assessment and help identify treatment focusing on normalizing these
disturbances. Therapeutic applications of chronobiology in bipolar disorder, such as specific psychosocial intervention,
light therapy and physical exercise are described. The study of sleep and circadian rhythms opens innovative avenues in
research concerning the pathophysiology of bipolar disorder, including the possible discovery of biomarkers, and may
lead to a better understanding of genes role in bipolar disorder regarding associations of some circadian genes
polymorphisms with bipolar disorder.
Keywords: Actigraphy, bipolar disorder, circadian rhythms, clock genes, light therapy, physical exercise.
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