Sleep disruption is closely intertwined with bipolar disorder, acting as both a symptom and a trigger for mood episodes. People diagnosed with bipolar disorder frequently experience varying sleep issues that can alter patterns during both manic and depressive states. Being mindful and protective of the sleep cycle remains vital for individuals with bipolar disorder, even when they feel stable and function well without symptoms.
How Mood Episodes Alter Sleep Patterns
The sleep issues experienced by individuals with bipolar disorder can vary significantly depending on whether they are facing highs or lows. During the highs of hypomania or mania, a person may suddenly need dramatically fewer hours of sleep to stay alert and energized. For instance, someone who regularly sleeps eight hours might feel rested on as little as four hours. Mania can be so stimulating that individuals do not feel tired despite running on much less rest.
Conversely, difficulties falling asleep are more likely to happen during depressive episodes. Patients may try to sleep but fail to fall asleep, experience disrupted sleep by waking up in the middle of the night and failing to return to sleep, or wake up too early.
Common Sleep Problems Associated With Bipolar Disorder
Research shows that several distinct sleep problems are common among people with bipolar disorder:
- Insomnia: Difficulty falling asleep, difficulty staying asleep throughout the night, waking up too early in the morning, or any combination of these.
- Hypersomnolence: Causes excessive daytime sleepiness, an increase in overall sleep time, and sleep inertia or ongoing sleepiness even after waking.
- Obstructive Sleep Apnea: Causes breathing to become shallow or briefly stop altogether during sleep, disrupting rest and leading to excessive daytime sleepiness.
- Parasomnias: Abnormal behaviors during sleep, such as sleep talking, sleepwalking (which can sometimes lead to injury), nightmares, excessive dreams, and hallucinations.
- Delayed Sleep-Wake Phase Disorder: Causes people to fall asleep and wake up much later than intended.
The Risks of Sleep Disruption
Sleep problems are common in people with bipolar disorder and can trigger new bipolar episodes. Studies indicate that insomnia and sleepiness are particularly prevalent even when a person is not experiencing an active mood episode, and treating these issues can improve quality of life. Even when someone attempts to make do on little sleep, repercussions can include increased moodiness, depression, worry, difficulty concentrating, and in a worst-case scenario, a higher risk for accidental death.
