Bipolar Insomnia
From Bipolar Lives: Living Better with Bipolar,
What is bipolar insomnia? How are bipolar disorder and insomnia connected?
Sleep disturbance is a significant feature of bipolar disorder, and is one of several criterion used for diagnosis, as it is a frequent symptom of both mania and depression.
During manic episodes its common to feel a decreased need for sleep, or suffer from insomnia.
But bipolar disorder and insomnia, and the associated sleep loss isnt just a symptom of mania; reduced sleep can also trigger manic episodes and is a good predictor of the onset of mania.
The depressed phase of bipolar is characterized by hypersomnia, where a person sleeps for extended periods or naps frequently throughout the day. This irregularity in sleeping patterns then tends to increase the risk of new episodes of mania or depression.
Interestingly, research has found that disrupted sleep patterns are
common in people with bipolar disorder even between bipolar episodes.
For reasons not yet understood, people with bipolar disorder have more
delicate body clocks.
The treatment of sleep disturbances and
maintaining a regular sleep/wake cycle are important components in the
prevention of mood episodes in bipolar disorder.
Circadian rhythms, bipolar and sleep
A circadian rhythm is approximately a 24-hour cycle in our biochemical, physiological and behavioral processes.
Reminder: Not sleeping but still feel energized? This is a classic sign of bipolar mania.
Our circadian rhythms govern sleep, hormonal function, appetite and body temperature.
Scientific research suggests that the Clock gene, which regulates the
bodys circadian rhythms, may be involved in the development of bipolar
disorder.
People with bipolar disorder generally have
irregularities in their circadian functions, including the body clock
and its sleep/wake cycle.
Exhaustion, sleeplessness and disruptions to sleep patterns can trigger a bipolar episode.
Establishing and maintaining a regular sleep/wake schedule, as well as stabilizing the circadian rhythm, are the primary elements of a relatively new treatment for bipolar disorder.
Some scientists believe that the increase of bipolar disorder in modern times is caused by the widespread use of artificial light. Before artificial light peoples sleep/wake cycles were regulated by the sun; it is possible that people who are genetically predisposed to bipolar disorder may develop the condition without the overall patterns of dark and light changing slowly and naturally.
Regular sleep helps bipolar
Sleep is an essential part of good health in all people and is vital to our well-being. Insufficient sleep causes significant health problems such as increased stress on the immune system, anxiety, depression and increased risk for gastrointestinal and cardiovascular disease.
Deep restful sleep is of particular importance to manic depressives, as bipolar disorder can impair judgment and lack of sleep can exacerbate this.
Daytime mood regulation and night-time sleep form a two-way relationship; once rhythms are disturbed such as with bipolar insomnia, a self-perpetuating cycle can begin where moods interfere with sleep and then disrupted sleep affects mood regulation the following day.
It is recommended that people suffering from bipolar insomnia and hypersomnia go to bed at the same time each night, and get up at the same time each morning.
Regular schedules and sleep patterns have a positive affect on
bipolar treatment and it is advised that activities that disturb normal
routines be avoided. Re-establishing and maintaining a regular sleep, meal and activity schedule is one of the reasons why a stay in a bipolar treatment center can be such so helpful.
Bipolar sleep tips
Some tips for establishing healthy sleep patterns to combat bipolar insomnia are:
1. Determine your need for sleep and meet it nightly.
2. Go to bed at the same time and get up at the same time.
3. Create a bed-time routine.
4. Limit napping to one short, early afternoon nap.
5. Use a journal to record any thoughts that might be keeping you awake.
6. Try relaxation tapes and techniques.
7. Exercise regularly.
8. Avoid caffeine.
9. Avoid alcohol.
10. Follow The Bipolar Diet to manage swings in blood sugar and mood, and improve overall stress levels.
Discussion Questions:
1.) Do you suffer from insomnia? How long has this been a challenge for you?
2.) What have you learned to do differently to promote sleep?
3.) How does insomnia worsen or exacerbate your mental health condition?
4.) What coping skills/medications have you utilized to seek relief? Have they worked? Why or why not?
@blitheSun94 - Very helpful! Thank you!
@Anomalia
Thank you for stopping by. Always a joy to read your name!
1.) Do you suffer from insomnia? How long has this been a challenge for you?
I have had insomnia since I was a young child. Not getting good sleep is holding me back-- I have little energy, so little motivation as well. The insomnia seems like the last piece of a puzzle I am trying to put together. Hypomania used to make up for the lack of sleep, balancing out the depressive symptoms, but I don't get them anymore, so....
2.) What have you learned to do differently to promote sleep?
I take an non-Benzo sleep aid and try to follow good sleep hygiene. I try to have a period of rest time before bed, with dim lights. I try to keep my bedroom at a good sleeping temperature, and I have cut caffeine out of my routine almost entirely.
3.) How does insomnia worsen or exacerbate your mental health condition?
Insomnia makes me feel in a low mood more, since I have trouble accomplishing tasks, and little energy to push me into being productive when I need to be.
4.) What coping skills/medications have you utilized to seek relief? Have they worked? Why or why not?
I have tried several nutritional supplemts, none of which worked. In the past, I had a psych doc who prescribed a low-dose Benzo for sleep, which worked pretty well. But my health care provider now will not prescribe one. :(
The whole sleep hygiene thing helps to get me to bed and start to sleep. But it doesn't help me with the repeated wakefulness that plagues me all night long.
Insomnia feels like the most major thing holding me back right now. It seems like if I could just solve this problem, my life would be 100x better.
@ladylazarus1971
Always such heart-filled replies. Thank you!
@blitheSun94
I just saw this article about seven potential sources of bipolar from a recent study that lists circadian rhythm (and 6 other things).
@Hoping4Harmony This is a really fascinating article. Thanks for sharing it!
@Hoping4Harmony
Thank you for the resource! I'll take a look. :)
@ladylazarus1971
Thank you for your answers-I can relate.
Insomnia is 1 of my current issues. I was trying melatonin-per psych md-I do think it was helping . I was falling asleep faster,deeper sleep when I did wake up during night-fell back asleep quickly. But i was feeling sooo groggy all next day.
Now, I'm goung to try lower dose of melatonin and take earlier.
@caughtinthemiddle Sounds like a good plan! Let us know how it works for you, please. :)
I have suffered from insomnia all my life. The bipolar diagnosos didn't help but, I am trying my best to get back on schedule. I will definatly try these tips.
@blitheSun94
1.) Do you suffer from insomnia? How long has this been a challenge for you? Insomnia has been an issue since my early teens. I can fall asleep almost anywhere, I just don't stay asleep. My average week of sleep before starting treatment for bipolar was 20-25hrs over 7 days. Go to bed around 0100, get up just after 0400.
2.) What have you learned to do differently to promote sleep? Having a routine for the last hour before heading to bed, and using blue light filters on all electronics from 1900-0700. I keep my screens dim anyways, but that filter helps.
3.) How does insomnia worsen or exacerbate your mental health condition? The more destabilized my sleep becomes, and the shorter it becomes, with more my odds of swinging up. I need 7-7.5hrs of sleep to stay more or less stable. Going to bed earlier and getting 8.5-9hrs is one of my first indicators of swinging down. I can do a day or two of 6hrs before things get messy.
4.) What coping skills/medications have you utilized to seek relief? Have they worked? Why or why not? I made good use of a few natural sleep aids over the years. I get a solid 8hrs of sleep, and a migraine the next day. Pretty much the days I don't wake up with reflux during the night, I still wake up between 0300 and 0500 at least once for 30-45min.
My psychiatrist have given me a sample of an old tricyclic that gained a new patent in 2010, as a hypnotic in low dose (3-6mg compared to 150-300mg). It apparently helps with sleep maintenance rather than falling asleep... but it's primary pathway is the h1 receptor, same as my antipsychotic. We'll see how the next week goes with that, last night was the 2nd night on it and reflux woke me up. Hopefully I can get things dialed in over the week (all the sample is) and it works, but I see her again in a month either way. It'll be great if I can get 7.5hrs consistantly without a migraine.
I also tend to eat and drink a lot after work,relaxing in the evening. So,then I have to wake up a lot to use the bathroom. I think i need to stop eating before 8pm.
And yes,I'm up right now with anxiety and insomnia!
If I didn't have to, I wouldn't sleep. Drinking is what gets me to sleep every night, usually after 2am.
@blitheSun94
Do you suffer from insomnia? How long has this been a challenge for you?
I suffer from insomnia about six years old when I entered college, and I went to study at night. Before that I had a relatively healthy routine that helped me prevent it, sleep and wake up at the same time every day and even had a journal to write down things just before bed, as suggested in the post.
During depression I usually have insomnia and hypersomnia.
Let me explain, depression drives me devoid of energy, but I always have many responsibilities, and as I am a naturally anxious person ... I simply despair and spend my nights awake and worried.
When the sun rises I go to sleep, and then I spend a lot of time in bed, even when I wake up (mainly due to gastritis) I soon force myself to sleep again, just so I do not have to face reality and my responsibilities.
What have you learned to do differently to promote sleep?
If I go to sleep early, sleep just enough (8 hours in my case), and leave the worries for the next day, I must have a healthier life.
I liked the part about writing the thoughts in a notebook, it already helped me once and I did not even realize it.
I also plan not to expose myself to the light displays for at least 30 minutes before going to bed.
How does insomnia worsen or exacerbate your mental health condition?
I think the worst part is it seems like the day is too short to do anything, I sleep too late, and I wake up very late.
And no matter how much I try to sleep and stay in bed, the next day it seems I did not even rest. I feel like I have not slept in months, I feel like a zombie, and I have to act like a normal, capable person, because no one would understand if I said I could not do my responsibilities.
What coping skills/medications have you utilized to seek relief? Have they worked? Why or why not?
I already tried sleeping pills, the problem is that I remain sleepy the next day, insomnia and hypersomnia make it difficult to know which medicine to take, so I gave up on it.
Hello! You
@windflowers ... Hi windflowers, I found this one :) and that all y'all call these "forum hunt" activity :) Really though, I'm going to bed now. It's after midnight! 
Good night @all of 7cups, Platy
@cyanPlatypus6370
thank you for participating!
Only recently been diagnosed with bipolar. In my first depressive stage since my diagnosis. MEGA sleep problems. Didn't realise sleep was affected by bipolar!
Quick question - what's the 'bipolar diet' that you mentioned?
Does anyone else also find that although they sleep a lot more in a depressive phase, that sleep doesn't really feel like good quality sleep? Almost like your missing out one of the normal sleep phases? If so, how do you guys deal with this?
@FollowTheFez
When I'm starting to swing down into depression, one of my first hints is sleeping more. Like barely make it through supper and go back to bed. Turn my 7-8hrs of sleep into 12.
My last deep depression I lost a few days.
On the same note, if I sleep less than 6hrs I'm likely swinging up.
@FollowTheFez exercising drains my energy completely and helps me to get a good night sleep.
