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The Bipolar Disorder and sleep connection has been confirmed by a substantial body of research.
Sleep deficits, such as being unable to fall or stay asleep, or any circumstance that leads to a Bipolar person not getting the total hours of sleep that they need can trigger mania AND is also a strong predictor of impending mania.
Too much sleep is a frequent symptom in Bipolar depression while not being able to get a full night’s sleep is a precursor to a manic episode or can occur at the onset and throughout a manic episode.
People with Bipolar Disorder can greatly benefit from monitoring their sleep patterns, such as establishing a sleep schedule.
It is also important to ensure a regular sleep routine where you rise and retire at about the same time, most days of the week (i.e., at least 5 to 6 days in a single week).
Sleep disturbances are a key symptom of both mania and depression, AND an excellent early warning system of a mood change.1
This is why sleep is one of the things that should ALWAYS be included on your bipolar mood chart.
Restoring and maintaining regular sleep is one of the reasons why a hospital admission or other treatment center intervention can be so helpful to people with Bipolar Disorder aside from any counseling or medication they may receive.
It is also one of the important principles underpinning Interpersonal and Social Rhythm Therapy (ISRT).ISRT is an exciting and effective psychosocial therapy for bipolar people that includes a lot of emphasis on regulating the individual’s sleep-wake cycles and daily routine.2
People with Bipolar Disorder usually have extremely sensitive circadian rhythms (i.e., the body’s internal clock). This makes it much more difficult for them to recover if their sleep or other aspects of their daily routine are disrupted. Most ‘typical’ people (i.e. those who do not have Bipolar Disorder) tend to make a much quicker recovery from a poor night’s sleep or other change in routine that messes with their body clock. Read more about Stable Sleep, Regular Routines and Bipolar Disorder.
Reminder
Trouble sleeping? See your treating doctor immediately, as this is both a symptom and a trigger for bipolar mania.
Sleep is just one factor in the complex issue of Bipolar Disorder and the circadian rhythm. People with Bipolar Disorder are known to be sensitive to changes in outdoor ambient light and to seasonal changes. Disruptions to the circadian rhythm due to travel and jet-lag have also been known to trigger mood swings.
Bright light therapy can ease Bipolar depression in some patients, according to a study published in the Journal of Bipolar Disorders.
New research shows a definite connection between the circadian rhythms and certain psychological responses, including the capacity to trigger relapses in patients with Bipolar Disorder.
bp Magazine, an important source of support and information for the bipolar community, recently ran a comprehensive article on bipolar sleep issues. This article explained:
“We are living in the middle of history’s greatest experiment in sleep deprivation and we are all part of that experiment,” says Robert Stickgold, PhD, a sleep research specialist and associate professor of psychiatry at Harvard Medical School. Dr. Stickgold makes this dramatic assertion in a recent Harvard Magazine article that also cites some startling statistics.
Good bipolar sleep hygiene is, in my opinion and that of Kay Redfield Jamison Ph.D, the single most critical factor in managing your Bipolar Disorder.
“Americans today sleep far less than people did 100 or even 50 years ago. Moreover, a 2005 poll by the National Sleep Foundation revealed that adult Americans sleep an average of 6.8 hours on weeknights. That’s more than an hour less than they need according to most sleep experts. Indeed, says Dr. Stickgold, “it’s not inconceivable…that we will discover that there are major social, economic, and health consequences to that experiment. Sleep deprivation doesn’t have any good side effects.” See The Quest for Sleep.
Disrupted sleep is also linked to obesity and a range of ther health problems, including higher smoking rates, less physical activity and more alcohol use. (Many readers will not be surprised by this given how long we have known that substance abuse and weight issues have a high co-morbidity with Bipolar Disorder.) A recent US government study has strongly tied irregular sleep to obesity and depression.
The most authoritative and trustworthy source of scientific research on Bipolar sleep is the textbook Manic-Depresive Illness: Bipolar Disorders and Recurrent Depression by Frederick Goodwin and Kay Redfield Jamison. The Appendix to Chapter 16 about Bipolar sleep is available online.
In summary: Bipolar Disorder sleep problems are very common, and often related to other health issues as well. If you or a loved one is Bipolar, make sure that you closely monitor sleep patterns and take action in case of:
1. Over-sleeping (more than 8-9 hours per night).
2. Insomnia.
3. Poor quality/disrupted sleep.
4. Sudden decrease in the need for sleep.
Talk to your medical advisor immediately as improving your sleep will promote stable moods as well.
You should also review this informative article on bipolar insomnia.
Mood charting has shown me just how important sleep really is to managing my own Bipolar Disorder.
I recently read a list of Kay Redfield Jamison’s top tips for managing Bipolar Disorder and preventing relapse, and sleep made the NUMBER ONE on her list.
My solution has been an investment in a Zeo Sleep Coach. My Zeo Sleep Coach showed me that I was not getting enough deep sleep or enough REM sleep and even helped me discover why (it related to dosage and timing of one particular med). I got my Zeo Sleep Coach from Amazon. The downside is that they are expensive.
In other words, not only will you discover the truth about every minute of sleep you do (or do not get) every night – you will also learn exactly what you need to do to fix your Bipolar sleep problems.
References:
1https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4935164/
2https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579327/
3 Comments
So many people I have spoken to who are bipolar have suffered sleep deprivation for much of their lives and I believe this could very often be the cause of their condition. I am wondering if any studies have found this link. I myself have, for a number of reasons outside my control, such as looking after ill relatives, etc., suffered severe sleep deprivation and have shown signs of psychosis but instead of being treated with bipolar medication have been given a strong sleeping tablet and after just one good night’s sleep have always returned to normal immediately. I have been told I am certainly not a text book case because of my quick return to complete normality but I am wondering how many others might only need a strong sleeping tablet and some really good sleep to bring about the same effect. It would save the health service a great deal of money so perhaps it is time to experiment.
Hey Lynette,
Is there any chance you can share the sleeping aid pill you use?
Thank you
As someone who has suffered from this condition for many years. Mania causes me not too sleep. I get caught up and obsessed with things to the point that I cannot sleep until I’ve fulfilled a task that’s not even possible. So, while I’d agree that not sleeping causes psychological issues. That could also be turned around by saying that the psychological issues are causing the lack of sleep.
If I’m in a depressed state then I’ll oversleep and feel tired and unmotivated to complete any task. I do like how doctors typically try to make sure you sleep well at first before handing out medications however sometimes it’s the obsessive thoughts that cause the lack of sleep so the issue becomes more serious during appointment times. I was given sleeping pills that didn’t affect me at all Like anything in life, there’s no one size fits all unfortunately. I can’t wait to see how the understanding of all mental illnesses progresses moving forward.