{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T07:06:54Z","timestamp":1788937614609,"version":"build-2803163510"},"reference-count":56,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Sleep 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\u2010pharmacological interventions specifically targeting sleep disturbances in BD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eleven studies met the inclusion criteria. Non\u2010pharmacological interventions, particularly cognitive behavioral therapy for insomnia adapted for bipolar disorder (CBTI\u2010BD), 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sleep\u2010focused interventions, especially behavioral strategies such as CBTI\u2010BD, 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\u2010specific recommendations can be made.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bdi.70179","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:27:42Z","timestamp":1788413262000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Managing Sleep in Bipolar Disorder: An Overview of Pharmacological and Non\u2010Pharmacological Interventions"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5795-5834","authenticated-orcid":false,"given":"Valentina","family":"Baldini","sequence":"first","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7216-4404","authenticated-orcid":false,"given":"Francesco","family":"Pasquino","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Iannucci","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3039-0190","authenticated-orcid":false,"given":"Noemi","family":"Venezia","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana De","family":"Ronchi","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1051-0472","authenticated-orcid":false,"given":"Giuseppe","family":"Plazzi","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia  Bologna Italy"},{"name":"IRCCS Istituto Delle Scienze Neurologiche di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4746-2061","authenticated-orcid":false,"given":"Lorenzo","family":"Pelizza","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0553-539X","authenticated-orcid":false,"given":"Marco","family":"Menchetti","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.copsyc.2020.02.001"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2869.2010.00826.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2014.06.006"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269881111421973"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2015.06.005"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12286"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-019-0526-2"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sby129"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2025.03.053"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2025.06.008"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2011.07.007"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(00)00969-0"},{"issue":"4","key":"e_1_2_9_14_1","first-page":"979","article-title":"The Effect of Mood on Sleep Onset Latency and Total Wake Time in Interepisode Bipolar Disorder","volume":"121","author":"Talbot L. S.","year":"2012","journal-title":"Journal of Abnormal Psychology"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920\u2010016\u20100717\u2010y"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2023.07.008"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2024.e30648"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0038655"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.recesp.2021.06.016"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12912"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2017.16101200"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.09.038"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852924000336"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2013.12050708"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2017.12.020"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0037911"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0322274"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0000000000000529"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2021.12.002"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/31.4.489"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2017.12.012"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.55.8.702"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.1876"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/0706743719892471"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.25m15826"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.705090"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1017\/S003329170500437x"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.2174\/1381612821666150619093448"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0602425103"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP275501"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41398\u2010024\u201003087\u20104"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/npr2.12069"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2022.114777"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.24m15424"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1192\/pb.26.12.460"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cub.2011.10.052"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.2174\/1871527320666210618103344"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920\u2010017\u20100816\u20104"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1017\/S109285292400021x"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2013.04.001"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2008.03.003"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2016.06.007"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.3298"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrn2868"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0032091"}],"container-title":["Bipolar Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bdi.70179","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/bdi.70179","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bdi.70179","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T06:30:05Z","timestamp":1788935405000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/bdi.70179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":56,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/bdi.70179"],"URL":"https:\/\/doi.org\/10.1111\/bdi.70179","archive":["Portico"],"relation":{},"ISSN":["1398-5647","1399-5618"],"issn-type":[{"value":"1398-5647","type":"print"},{"value":"1399-5618","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2025-06-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70179"}}