CoChat
Sign Up
Cited by 162Bipolar Disorder and TreatmentCircadian rhythm and melatoninSleep and related disorders

Treatment of a Rapidly Cycling Bipolar Patient by Using Extended Bed Rest and Darkness to Stabilize the Timing and Duration of Sleep

Wehr, Thomas A., Turner, Erick H., Shimada, Jeffrey M., Lowe, Catherine H., Barker, Charles, Leibenluft, Ellen·1998·Biological Psychiatry
DOI 10.1016/s0006-3223(97)00542-8
Open this paper in CoChat — free account

Abstract

Background The modern practice of using artificial light to extend waking activities into the nighttime hours might be expected to precipitate or exacerbate bipolar illness, because it has been shown that modifying the timing and duration of sleep can induce mania in susceptible individuals. With this possibility in mind, we treated a patient with rapidly cycling bipolar illness by creating an environment that was likely to increase and to stabilize the number of hours that he slept each night. Methods We asked the patient to remain at bed rest in the dark for 14 hours each night (later this was gradually reduced to 10 hours). Over a period of several years, his clinical state was assessed with twice-daily self-ratings, once-weekly observer ratings, and continuous wrist motor activity recordings. Times of sleeping and waking were recorded with sleep logs, polygraphic recordings, and computer-based event recordings. Results The patient cycled rapidly between depression and mania and experienced marked fluctuations in the timing and duration of sleep when he slept according to his usual routine, but his sleep and mood stabilized when he adhered to a regimen of long nightly periods of enforced bed rest in the dark. Conclusions Fostering sleep and stabilizing its timing by scheduling regular nightly periods of enforced bed rest in the dark may help to prevent mania and rapid cycling in bipolar patients.

Integrity signals

Registry

Crossref · 10.1016/s0006-3223(97)00542-8

Cites

33 of 33 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Patient 9 achieved a complete remission when he stayed in total darkness from 1800 hours to 0800 hours every night.

    “Consistent with this prediction, Patient 9 achieved a complete remission when he stayed in total darkness from 1800 hours to 0800 hours every night.”

    From Bipolar mood cycles and lunar tidal cycles (2018) · cites this paper as [10]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Wehr, T. A., Turner, E. H., Shimada, J. M., Lowe, C. H., Barker, C., & Leibenluft, E.
Affiliations
National Institute of Mental Health (US)
Corresponding author
Wehr, Thomas A.
ORCID
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
1998-06
Volume
43
Issue
11
Pages
822-828
ISSN
0006-3223 (ISSN-L)
DOI
10.1016/s0006-3223(97)00542-8
OpenAlex
W2015143244
Cited by
162
References
33
Citations by year
2026: 2 · 2025: 4 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 8 · 2019: 5 · 2018: 7 · 2017: 5 · 2016: 9 · 2015: 8 · 2014: 7 · 2013: 4 · 2012: 4
FWCI
3.99
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords
rapid cycling bipolar disorder, sleep timing, sleep duration, darkness, artificial light exposure, depression, sleep-wake cycle, sleep polygraphy
MeSH terms
Bed Rest, Bipolar Disorder, Circadian Rhythm, Darkness, Follow-Up Studies, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Signal Processing, Computer-Assisted, Polysomnography

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review