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Bipolar Disorder Health Center

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Bipolar Disorder and Sleep Problems

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How Bipolar Disorder Affects Sleep: Get Better Sleep With Bipolar Disorder

Changes in sleep that last for more than two weeks or interfere with your life can point to an underlying condition. Of course, many things may contribute to sleep problems. Here's what you need to know about the many connections between bipolar disorder and sleep and what you can do to improve your sleep.

How Bipolar Disorder Affects Sleep

Bipolar disorder may affect sleep in many ways. For example, it can lead to:

  • Insomnia, the inability to fall asleep or remain asleep long enough to feel rested (resulting in feeling tired the next day).
  • Hypersomnia, or over-sleeping, which is sometimes even more common than insomnia during periods of depression in bipolar disorder.
  • Decreased need for sleep, in which (unlike insomnia) someone can get by with little or no sleep and not feel tired as a result the next day.
  • Delayed sleep phase syndrome, a circadian-rhythm sleep disorder resulting in insomnia and daytime sleepiness.
  • REM (rapid eye movement) sleep abnormalities, which may make dreams very vivid or bizarre.
  • Irregular sleep-wake schedules, which sometimes result from a lifestyle that involves excessive activity at night.
  • Co-occurring drug addictions, which may disrupt sleep and intensify pre-existing symptoms of bipolar disorder.
  • Co-occurring sleep apnea, which may affect up to a third of people with bipolar disorder, which can cause excessive daytime sleepiness and fatigue.

During the highs of bipolar disorder (periods of mania), you may be so aroused that you can go for days without sleep without feeling tired the next day. For three out of four people with bipolar disorder, sleep problems are the most common signal that a period of mania is about to occur. Sleep deprivation, as well as jet lag, can also trigger manic or hypomanic episodes for some people with bipolar disorder.

When sleep is in short supply, someone with bipolar disorder may not miss it the way other people would. But even though you seem to get by on so little sleep, lack of sleep can take quite a toll. For example, you may:

  • Be extremely moody
  • Feel sick, tired, depressed, or worried
  • Have trouble concentrating or making decisions
  • Be at higher risk for an accidental death

You may already know the ups and downs of how bipolar disorder affects sleep. But even between acute episodes of bipolar disorder, sleep may still be affected. You may have:

  • Heightened anxiety
  • Worries about not sleeping well
  • Sluggishness during the day
  • A tendency to have misperceptions about sleep

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