{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T12:25:57Z","timestamp":1793881557792,"version":"4.7.0"},"reference-count":50,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"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":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Among patients with bipolar disorder, chronic insomnia is a common comorbidity that adversely affects mood instability, quality of life, disability, accelerated aging, and increased suicide risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This matched case\u2013control study characterized the clinical features of insomnia in a bipolar disorder clinic population and identified biological and genetic correlates affecting diurnal patterns of cortisol, inflammation, and aging. Cross\u2010sectional data were collected from 22 patients with bipolar disorder and chronic insomnia (BD\u2009+\u2009INS), and 22 age\u2010 and sex\u2010matched bipolar disorder patients without insomnia (BD\u2010INS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      BD\u2009+\u2009INS patients reported sleep problems independent of current mood state with a mean insomnia duration of 22.5\u2009years. Compared to BD\u2010INS participants, BD\u2009+\u2009INS patients reported more disturbed sleep, more use of daytime anxiolytics, and reduced use of antidepressants, but reported no differences in overall functioning, quality of life, or severity of mood episodes. Compared to matched participants, BD\u2009+\u2009INS patients also had reduced waking cortisol, increased levels of the inflammatory cytokine tumor necrosis factor \u03b1 (TNF\u2010\u03b1), and were more likely to be homozygous for a genetic variant in\n                      <jats:italic>TERT<\/jats:italic>\n                      previously linked with short telomere length and premature aging.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings suggest that chronic insomnia in BD can persistently alter sleep independent of mood symptoms and may be associated with distinct biological features, including cortisol and inflammatory systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bdi.70187","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:45:18Z","timestamp":1789987518000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and Biological Characterization of Bipolar Disorder Patients With Chronic Insomnia Reveals Cortisol Reductions, Elevated\n                    <scp>TNF<\/scp>\n                    \u2010\u03b1, and Increased Genetic Risk for Accelerated Aging"],"prefix":"10.1111","volume":"28","author":[{"given":"Kayla E.","family":"Rohr","sequence":"first","affiliation":[{"name":"University of California San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles B.","family":"Schaffer","sequence":"additional","affiliation":[{"name":"University of California Davis  Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda C.","family":"Schaffer","sequence":"additional","affiliation":[{"name":"Sutter Community Hospitals  Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas E.","family":"Nordahl","sequence":"additional","affiliation":[{"name":"University of California Davis  Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei\u2010An","family":"Shih","sequence":"additional","affiliation":[{"name":"University of California San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3013-2333","authenticated-orcid":false,"given":"John R.","family":"Kelsoe","sequence":"additional","affiliation":[{"name":"University of California San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6219-4945","authenticated-orcid":false,"given":"Michael J.","family":"McCarthy","sequence":"additional","affiliation":[{"name":"University of California San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14\u20101617"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2008.08010129"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2016.148"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.15683"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2025.102137"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2008.08010098"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.162.1.50"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2024.105575"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.154.10.1412"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2019.00501"},{"issue":"2","key":"e_1_2_10_12_1","first-page":"201","article-title":"Sleep Reduction as a Final Common Pathway in the Genesis of Mania","volume":"144","author":"Wehr T. 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