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Sleep-Loss as a Possible Mediator of Diverse Causes of Mania

  • Thomas A. Wehr (a1)


When sleep duration and mood were monitored longitudinally in a 59–year-old woman with bipolar illness, sleep loss appeared to mediate the triggering of mania by psychosocial and pharmacological precipitating factors. This interpretation was supported by observations that mania could repeatedly be induced experimentally by depriving her of sleep for one night. The patient's data illustrate how sleep-loss might be a preventable cause of mania in a variety of situations.



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Bunney, W. E. Jr. & Hamburg, D. A. (1963) Methods for reliable longitudinal observation of behavior. Archives of General Psychiatry, 9, 280294.
Dilsaver, S. C. & Greden, J. F. (1984) Antidepressant withdrawal-induced inactivation (hypomania and mania): mechanism and theoretical significance. Brain Research, 7, 2948.
Jones, B. D., Steinberg, S. & Chouinard, G. (1984) Fast-cycling bipolar disorder induced by withdrawal from long-term treatment with a tricyclic antidepressant. American Journal of Psychiatry, 141, 108109.
Kusalic, M. & Ghadirian, A. M. (1990) Paradoxical mood changes during pharmacotherapy of bipolar patients. Biological Psychiatry, 27, 1183.
Mirin, S. M., Schatzberg, A. F. & Creasey, D. E. (1981) Hypomania and mania after withdrawal of tricyclic antidepressants. American Journal of Psychiatry, 138, 8789.
Turkington, D. & Gill, P. (1989) Mania induced by lorazepam withdrawal: A report of two cases. Journal of Affective Disorders, 17, 9395.
Wehr, T. A., Wirz-Justice, A., Goodwin, F. K., et al (1982) 48—hour sleep-wake cycles in manic-depressive illness: Naturalistic observations and sleep deprivation experiments. Archives of General Psychiatry, 39, 559565.
Wehr, T. A., Sack, D. A. & Rosenthal, N. E. (1987) Sleep reduction as a final common pathway in the genesis of mania. American Journal of Psychiatry, 144, 201204.
Wehr, T. A. (1989) Sleep loss: A preventable cause of mania and other excited states. Journal of Clinical Psychiatry, 50 (suppl.), 816.
Wehr, T. A. (1990) Effects of wakefulness and sleep on depression and mania. In Sleep and Biological Rhythms (eds Montplaisir, J. & Godbout, R.), pp. 4286. London: Oxford University Press.
Wiegand, M., Rieman, D., Schreiber, W., et al (1991) Reversal of antidepressant sleep deprivation effects by daytime naps. In Integrative Biological Psychiatry (eds Emmrich, H. M. & Wiegand, M.). Berlin: Springer Verlag (in press).

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Sleep-Loss as a Possible Mediator of Diverse Causes of Mania

  • Thomas A. Wehr (a1)


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