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How Insomnia and Bipolar Disorder Go Hand in Hand


For those suffering from bipolar disorder, insomnia can be a consistent issue. During the manic phase of untreated bipolar disorder, people do not feel the drive to sleep the way others do. Paradoxically, during the depressive cycle of the disorder, people may not be able to sleep either. Some of the medications people may take to treat these disorders can greatly interfere with sleep. The amount of sleep people need to function properly may vary from person to person, but everyone needs sleep for their general health. Insomnia gets in the way of this for people suffering from bipolar disorder.

Many individuals have trouble getting to sleep, while others have problems staying asleep. Insomnia can be either acute or chronic. Acute insomnia is defined as occurring for one week to one month, whereas chronic insomnia occurs at least three nights a week for over a month.

Sufferers of insomnia deal with symptoms like:

  • Trouble falling asleep
  • Trouble staying asleep
  • Waking up earlier than normal
  • Excessive fatigue during daylight hours
  • Feeling tired immediately upon waking up
  • Irritability, depression, or anxiety
  • Issues with memory, concentration, or attention
  • Constantly worrying about sleep

People with bipolar disorder already have issues moderating their behaviors, particularly risk-taking behaviors. Insomnia can affect judgment, which can be especially difficult when coupled with other behaviors. Sufferers of bipolar disorder may already have cognitive impairment, and the effects of insomnia can exacerbate this impairment by making it harder to concentrate or remember things.

Bipolar disorder is characterized by a cycle of manic and depressive episodes. Insomnia can make depression worse than normal and the depression can conversely lead to insomnia. It is a vicious cycle. Insomnia tends to be a hallmark of an oncoming manic episode. This can give an alert to patients, their clinicians, and family members that their medication may not be working properly, or that a dosage adjustment is needed.

Lack of sleep due to insomnia can be quite difficult to live with, but there are some things that can be done to treat it. Healthy sleeping habits should be followed. Going to bed and waking up at regular times every day should be at least attempted. Avoiding caffeine and electronics before bed can help as well. Creating an environment conducive to sleep, like a cool, dark bedroom with a comfortable bed can be very beneficial. Cognitive behavioral therapy for bipolar patients can help alleviate stressors and contribute to restful sleep. For severe cases of insomnia, prescription medications like benzodiazepine may be necessary. A change in bipolar medications may also be in order. For someone suffering from bipolar disorder, an underlying physical issue may be hindering sleep, like breathing issues.

Insomnia and bipolar disorder, unfortunately, go together very often. It is important to adequately treat insomnia in order to live a healthier, more restful life.

Ref: LaBouff, L; Insomnia and Bipolar Disorder; Psychcentral website; accessed 11/30/2017.