Sleep deprivation

What is sleep deprivation for bipolar disorder?

Sleep deprivation, or ‘wake therapy’, involves being deprived of total sleep for approximately 36 hours straight, or partially sleeping for only 3 to 4 hours followed by 20 to 21 hours of wakefulness. This therapy has been associated with rapid improvements in depressed mood but may also trigger mania. Studies have used various treatment formats in the number, timing, and duration of sleep deprivation cycles to determine which works best for people with bipolar disorder.

What is the evidence for sleep deprivation in people with bipolar disorder?

Moderate quality evidence shows total sleep deprivation can improve depression in around half of people receiving the treatment. It is particularly effective when accompanied by mood stabilizers or antidepressants. There were no further improvements when adding sleep phase advance or bright light treatment, or when adding more than one sleep deprivation exposure.

Moderate to low quality evidence finds a medium-sized improvement in depression with total sleep deprivation plus medication compared to medication alone. This effect may remain for up to 4 weeks post-treatment. Adding mood medication after 10 days of total sleep deprivation treatment improved depression and increased rates of remission by 3 months. Around 4% of patients had an episode of mania or hypomania with total sleep deprivation.

August 2021

Image: ©Nikki Zalewski –

Last updated at: 1:58 pm, 15th February 2022
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