How Sleep and Bipolar Disorder Interact
Bipolar Disorder, Depression, and Sleep Problems
Sleep disorders are very public in people with bipolar disorder and appear to play a significant role in the cycling of the disorder.
Insomnia – Insomnia is a disorder which contains not only difficulty in falling asleep, but difficulties staying asleep or getting too little sleep. Insomnia is common with many physical and mental health situations. In those with bipolar disorder, hypomania can often lead to insomnia due to hyperarousal. When this happens, treatment of the underlying condition (hypomania or mania due to bipolar disorder) is a goal of treatment.
Delayed sleep phase syndrome – Delayed sleep phase syndrome is a common circadian rhythm disturbance. Common in people with depression, several of the medications used to treat bipolar disorder can lead to delayed sleep phase syndrome. Treatment may contain a combination of chronotherapy, light therapy, and/or melatonin.
Irregular sleep-wake schedule – When people with bipolar disorder have a lack of routine—such as those who are addicted to alcohol or drugs and are awake at night and sleep during the day—the irregular cycle can greatly interfere with appropriate treatment of the disorder. Treatment focuses on treating the cause which keeps them up at night.
Nightmares – Vivid dreams, nightmares, and night terrors may also affect people with bipolar disorder. As with insomnia, the goal of treatment is to best treat the underlying bipolar disorder.
Sleep as a Precipitant of Mania with Bipolar Disorder
What may surprise you is that reduced sleep isn’t just a symptom of mania—a short night can actually precipitate manic and hypomanic episodes.
“Social rhythm disruption” is some disturbance in routine affecting the sleep/wake cycle; it can be as simple as staying up extra late to watch a movie on television or getting wrapped up in an interesting online chat session, or as serious as being unable to sleep due to a family member’s serious illness or death.
Could Sleep Disorders Actually Lead to Bipolar Disorder?
Some scientists believe that the cause the incidence of bipolar disorder has risen in modern times is the development of bright artificial light. Once upon a time, most people’s sleep/wake cycles were regulated by the sun. The artificial light changed all that and made it more likely that people who have a genetic predisposition toward bipolar disorder would actually develop the situation.
While a causal relationship hasn’t been proven, sleep disturbances in people with bipolar disorder have also been linked with changes in the microstructure of the white matter of the brain.
How to Cope
Just as sleep disorders due to bipolar disorder need to be addressed (see above,) those which could worsen bipolar disorder need to be addressed as well.
If you’re suffering from insomnia, good sleep hygiene is critical. Experts recommend that you:
Go to bed and get up at the same time every day
Avoid naps, especially naps in the late afternoon. If you must nap, try to limit your rest to around one hour.
Avoid heavy meals a few hours before retiring.
If you can’t sleep after a certain amount of time (for example, 15 minutes) get out of bed and do something. It’ still significant to get up at your regular time the next morning, even if you will have less than seven hours of sleep.
If you are coping with hypersomnia (sleeping too much,) it’s often advised that you gradually reduce the amount of time you spend sleeping by using an alarm clock.
Bottom Line
If you or a loved one suffer from any type of mood disorder, pay attention to the sleep/wake patterns of the person involved. If you identify insomnia, hypersomnia, poor-quality sleep and/or reduced essential for sleep, this should be brought to your/your loved one’s doctor’s attention right away.
