Synchrony of sleep-wake cycles with lunar tidal cycles in a rapid-cycling bipolar patient

Is there an association between the lunar phases and hospital admission for different episode types in bipolar disorder? A retrospective study in northern China

The effects of the moon on mental activities remain contentious. Few studies have investigated associations between lunar phases and different types of bipolar disorder (BD) episodes. In the current study, 7,452 patients with BD from three hospitals were enrolled. Patients were divided into two groups on the basis of episode types, and the effects of lunar phase were examined for each type. The cosinor analysis revealed moon-related rhythmicity in admissions for BD in a period of 14.75 days. There were fewer admissions around the new moon and the full moon. There was no significant difference between different groups in acrophase. There was possibly a temporal lag between the onset of BD and hospitalization. Thus, it is too early to draw firm conclusions about the impact of lunar phases on BD. Sleep might be a middle way from moon effect to admissions of BD. These results have implications for future disease prevention strategies and research.

Longitudinal observations call into question the scientific consensus that humans are unaffected by lunar cycles

Recent longitudinal observations show that human menstrual cycles, sleep-wake cycles and manic-depressive cycles can become synchronized with lunar cycles, but do so in uniquely complex and heterogeneous ways that are unlikely to have been detected by past studies. Past studies' negative results have given rise to a scientific consensus that human biology and behavior are unaffected by lunar cycles. The recent observations show that synchrony can be temporary, and can occur with more than one type of lunar cycle, more than one phase of a lunar cycle and more than one resonant frequency of a lunar cycle. Given the variability of human responses to lunar cycles, aggregate analyses used in almost all previous studies would likely have cancelled out individuals' responses and led to false negative results. In light of these observations, the question of lunar influence should be investigated further, with longitudinal observations and case-by-case analyses of individuals' data.

Moonstruck sleep: Synchronization of human sleep with the moon cycle under field conditions

Before the availability of artificial light, moonlight was the only source of light sufficient to stimulate nighttime activity; still, evidence for the modulation of sleep timing by lunar phases is controversial. Here, we use wrist actimetry to show a clear synchronization of nocturnal sleep timing with the lunar cycle in participants living in environments that range from a rural setting with and without access to electricity in indigenous Toba/Qom communities in Argentina to a highly urbanized postindustrial setting in the United States. Our results show that sleep starts later and is shorter on the nights before the full moon when moonlight is available during the hours following dusk. Our data suggest that moonlight likely stimulated nocturnal activity and inhibited sleep in preindustrial communities and that access to artificial light may emulate the ancestral effect of early-night moonlight.

Commentary on "Synchrony Between Bipolar Mood Cycles and Lunar Tidal Cycles Ended After Initiation of Light Treatment and Treatment of Hypothyroidism"

According to a recent report, mood cycles in a group of patients with rapid cycling bipolar disorder oscillated in synchrony with lunar gravimetric tides. Mood switches in a 67-year-old woman with rapid cycling bipolar II disorder on lithium maintenance treatment were assessed with a χ periodogram and a χ analysis of the mood switches in relation to the lunar tidal cycle. During a period when she was treated with nortriptyline and her thyroid-stimulating hormone levels were elevated, her mood switches had a significant (P<0.05) 29- to 30-day periodicity, and the χ analysis showed that the switches were distributed nonrandomly in relation to the spring-neap lunar tidal cycle (P<0.0001); 14 of 15 switches occurred within 2 days of the spring tides. After nortriptyline was discontinued, thyroid-stimulating hormone levels were normalized with treatment with levothyroxine, and consistent bright light treatment was started, the synchrony between mood cycles and lunar cycles disappeared, and rapid cycling eventually stopped. The possibility that lunar mood cycling is sometimes contingent on antidepressant treatment, decreased thyroid function, and certain types of light-dark cycles needs to be considered in future research on lunar tidal influences on the course of bipolar illness.

Synchrony Between Bipolar Mood Cycles and Lunar Tidal Cycles Ended After Initiation of Light Treatment and Treatment of Hypothyroidism

According to a recent report, mood cycles in a group of patients with rapid cycling bipolar disorder oscillated in synchrony with lunar gravimetric tides. Mood switches in a 67-year-old woman with rapid cycling bipolar II disorder on lithium maintenance treatment were assessed with a χ periodogram and a χ analysis of the mood switches in relation to the lunar tidal cycle. During a period when she was treated with nortriptyline and her thyroid-stimulating hormone levels were elevated, her mood switches had a significant (P<0.05) 29- to 30-day periodicity, and the χ analysis showed that the switches were distributed nonrandomly in relation to the spring-neap lunar tidal cycle (P<0.0001); 14 of 15 switches occurred within 2 days of the spring tides. After nortriptyline was discontinued, thyroid-stimulating hormone levels were normalized with treatment with levothyroxine, and consistent bright light treatment was started, the synchrony between mood cycles and lunar cycles disappeared, and rapid cycling eventually stopped. The possibility that lunar mood cycling is sometimes contingent on antidepressant treatment, decreased thyroid function, and certain types of light-dark cycles needs to be considered in future research on lunar tidal influences on the course of bipolar illness.

Hypothesis: Folklore perpetuated expression of moon-associated bipolar disorders in anecdotally exaggerated werewolf guise

We hypothesize that Moon-associated signals, recently linked to rapid cycling bipolar disorder, may have triggered extremely rare instances of extreme manic and aggressive behaviour that may be compatible with the folklore of the werewolf. Very limited literature on instances of clinical lycanthropy or violent/manic/madness behaviour in association with the Moon may be due to very rare lycanthropic psychosis and not knowing which signal(s) could determine Moon-mood associations. Mechanistically, lunar effects related to bipolar disorder, mood changes, and psychosis could involve either, or a combination, of the following: (i) some as of yet non-measurable signal or undefined geoelectric/geomagnetic receptor or higher sensitivity in some humans, (ii) Moonlight affecting sleep and/or circadian rhythm, (iii) perinatal imprinting of susceptibility, (iv) lunar-periodic growth, and subsequent consumption, of or exposure to psychotropic agents. Importantly, remarkable recent studies (2018) suggest that links between some Moon cycles and bipolar disorder are conceivable. Further observations suggest a role for periodic changes in lunar distances in combination with the Earth and Sun positions. Targeted research could use insight from astrophysicists. If causal links between Moon signals and mood were corroborated, sufferers may benefit from improved disease understanding. Herein, we systematically review the literature and synthesize the evidence for and against the hypothesis. The werewolf myth could become another instance of folklore popularizing biological variation worthy of investigation such as the book characters created by the psychiatrist Hoffmann in 1845 as a Christmas present for his son; namely, 'Struwelpeter' and 'Zappel-Philipp' (shock-headed Peter and fidgety-Philipp): Their conspicuous characteristics have since been linked to genetic uncombable hair syndrome and ADHD, respectively. Overall, rather than dismissing (seemingly) trivial and uncertain concepts as 'just folklore', scientists should grapple with the roots, causes, and significance of traditions and tales, including the werewolf legend.

Bipolar mood cycles associated with lunar entrainment of a circadian rhythm

In bipolar disorder, episodes of depression and mania are associated with dramatic disturbances in sleep, which experiments show are likely to contribute to the pathogenesis of the episodes. A recent finding that 18 patients' manic-depressive cycles oscillated in synchrony with biweekly surges in amplitude of the moon's tides provided a clue to the cause of the sleep-disturbances. Analyses of one of the patients' sleep-wake cycles suggest that his mood cycles arose when a circadian rhythm that normally is entrained to dawn and controls the daily onset of wakefulness became entrained instead to 24.8-h recurrences of every second 12.4-h tidal cycle. The finding provides the basis for a comprehensive description of the pathogenesis and pathophysiology of the mood cycle.