Bipolar Disorder and Sleep Problems
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
- 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 drug-seeking behavior at night
During the lows of bipolar disorder, you may have overwhelming feelings of hopelessness, sadness, and worthlessness. These can interfere with your sleep.
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.
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
Get Better Sleep With Bipolar Disorder
Disrupted sleep can really aggravate a mood disorder. A first step may be figuring out all the factors that may be affecting sleep and discussing them with your doctor. Keeping a sleep diary may help. Include information about:
- How long it takes to go to sleep
- How many times you wake up during the night
- How long you sleep all night
- When you take medication or use caffeine, alcohol, or nicotine
- When you exercise and for how long
Certain bipolar medications may also affect sleep as a side effect. For example, they may disrupt the sleep-wake cycle. One way to address this is to move bedtime and waking time later and later each day until you reach your desired goal. Two other ways to handle this situation are bright light therapy and use of the hormone melatonin.