Disordered sleep patterns can make bipolar disorder worse
Bipolar disorder often goes hand in hand with erratic sleep patterns. If you improve one, you’ll likely help the other.
Troubled sleep ruins anybody’s day. But when you have bipolar disorder, the relationship between your sleep and your moods is much more intense. Extreme shifts between mania and depression, usually bookended by symptom-free periods of calm, may contribute to troublesome changes in your sleep cycle.
Here’s how someone with bipolar disorder experiences sleep:
Before a manic episode. You might start sleeping less in the days leading up to a manic episode. This might be the earliest symptom of a developing episode or lack of sleep could be what triggers mania.
During mania. In the middle of a manic episode, you may sleep very little, yet feel like you have plenty of energy. When you do drop off, research shows mania is often accompanied by abnormal REM sleep—the phase of sleep in which dreaming occurs.
During depression. Some people sleep way too much, while others suffer severe insomnia. REM sleep is often disturbed during depression, too.
During calm. Even during periods of calm, your sleep patterns may differ from that of someone without the disorder. You may still have mild problems with sleeping too much or too little.
How are bipolar disorder and sleep linked? Growing research points to a malfunction in the circadian system—a group of body rhythms that follow a 24-hour cycle, telling your brain when to fall asleep and wake up. Sleep rhythms and moods are controlled by some of the same areas of the brain, and they’re also affected by some of the same brain chemicals, including dopamine and serotonin.
Though your sleep rhythms respond to natural cues, such as sunlight, they’re also affected by social cues, such as your daily schedule. That’s why doctors suggest people stick to a consistent bedtime and wake-up time, even on weekends. When you have bipolar disorder, following a steady sleep routine may have the added benefits of keeping your moods on a more even keel and preventing or shortening some bipolar episodes.
One treatment that studies the power of a good night’s sleep is social rhythm therapy (SRT). In SRT, you learn to make positive changes in your daily routine and sleep schedule.
For instance, if you look back on a recent manic episode, you might realize you were out late with friends for three nights in row just before the episode started. Your therapist can help you stick to plans to head home by 11 p.m. going forward.
And follow these tips that promote sound sleep:
Exercise. Just don’t do it within three hours of bedtime.
Don’t smoke. Nicotine is a stimulant.
Limit caffeine. Its effects can take up to eight hours to wear off.
Prepare for sleep. Keep your bedroom dark and quiet. Put the thermostat at a comfortably cool temperature. Move the TV and other electronics out of the room.
Relax before bed. Try a soothing ritual, such as soaking in a warm bath or listening to soft music.
Follow your bipolar disorder treatment. Reducing mania and depression helps decrease your sleep problems.