A 31-year-old woman with bipolar I disorder, currently euthymic on lithium and lamotrigine, is referred for adjunctive psychotherapy after her third manic episode in two years. Her PMHNP notes that each episode was preceded by significant disruptions in sleep-wake patterns: once after rotating to night shifts, once during international travel, and once after her newborn disrupted her sleep schedule. The therapist introduces a daily log tracking her wake time, first contact with another person, start of work, dinner time, and bedtime, alongside targeted work on her interpersonal stressors.