The bipolar disorder, characterized by mania episodes, hypomania and depression is a serious recurring perturbation associated not only to severe sleep pattern disturbances but also to a significant circadian disruption. These fluctuations/changes have a great impact on quality of life and in the disease prognosis.

Review the main sleep pattern alterations/fluctuations observed in the bipolar disorder, their clinical impact and the involved pathophysiological mechanisms.

Complaints about sleep pattern changes may occur during any phase of the disease. These include frequent night-time awakenings, poor sleep quality, reduction of the total sleeping time (TST) and decreased latency and increased density of REM sleep. In the depressive phase, patients also reveal insomnia/hypersomnia, difficulty waking up and excessive daytime sleepiness.

Sleep pattern fluctuations are frequent in bipolar disorders and have a great clinic implication as a symptom. The corrections of sleep disturbances observed in bipolar disorder should be considered a therapeutic priority, since they prevent symptoms recurrence and smooth the socio-professional integration, thus providing greater success in patient’s rehabilitation and quality of life.