Bipolar Disorder

Understanding Sleep Complications in Bipolar Disorder

Table of Content

Dysregular sleep is alright every now and then. It is not okay if it becomes a pattern. If your patterns suggest that you sleep for over 12 hours, or not be able to sleep at all at night, then one need to change the pattern. Sleeping patterns, as studies have suggested, have a great impact on those with Bipolar disorder

The Connection Between Bipolar Disorder and Sleep

Sleep disturbances are a core feature of Bipolar disorder, and they are a part of both the manic (or hypomanic) and the depressive state. 

Sleep Disturbances as Symptoms of Bipolar Disorder

It is seen that most people will experience some sort of sleeping problems when dealing with Bipolar disorder. This symptom can further trigger episodes of the disorder, which becomes a cyclical feature—and tougher to deal with as well. 

Sleep and Mania

It is very likely that one will experience sleep problems just before or during an episode of mania. They usually will have less need for sleep. 

1. Decreased Need for Sleep

This can also manifest as struggling to fall asleep at night, or even the sleep getting disturbed at night. They can feel not too tired, even though they aren’t sleeping as much, which is a classic sign that the manic state is active

2. Insomnia and Mania

Quality of sleep, as well as the number of hours spent sleeping, will end up falling when experiencing mania. Disturbed sleep patterns as well not not being able to sleep can become common, which is a telltale sign of an episode. 

Sleep and Depression

The cyclical nature of switching between manic states and depressive states is very common with Bipolar disorder, and with depression comes even a lot more sleep problems. 

1. Hypersomnia and Depression

This is seen right after one experiences a manic episode, where one’s body tries to compensate for the energy spent in the manic state. This crash can make the symptoms of depression worse, which can make the episode even.

2. Insomnia and Depression

Insomnia—wherein one struggles to stay asleep or fall asleep—can also be seen in the case of depression. This can be quite confusing as insomnia is common with both manic and depressive states, but one still needs to keep in mind to get the required help and guidance. 

How Does Bipolar Disorder Affect Sleep

There is a decreased need for sleep, as well as increased trouble falling asleep. One can also find it difficult to stay asleep or wake up too early, which can also be an effect of Bipolar disorder on sleep. 

Insomnia and Bipolar Disorder

Trouble falling asleep, whether one is in a manic state or a depressive state, is a common symptom of Bipolar disorder. The excitement, or the lack of it, is something that can keep one awake at night, and these are very interconnected.

Hypersomnia During Depressive Episodes

Hypersomnia, or excessive sleep, is also a common feature of Bipolar disorder and is often present during the depressive state of the condition. This is usually the case even if one gets enough sleep during the day—and, despite it, is still sleepy. 

Decreased Need for Sleep During Manic Episodes

The manic state suggests a large burst of energy, allowing one to sleep very little and keep their days at a bare minimum amount of sleep.  During the manic stage, one feels no need to sleep, even though the amount of sleep needed by the body is still the same. 

Delayed Sleep Phase Syndrome

This is the case when their sleep pattern gets delayed by an hour or two, making their daily routines very challenging. They go to sleep later and, therefore, only wake up later, much later than what they need to for their lifestyle. 

REM Sleep Abnormalities

REM sleep can be affected in Bipolar disorder. The density of REM sleep is usually increased, and REM latency is seen to decrease. Regulation of sleep is, therefore, seen to be fractured. 

Irregular Sleep-Wake Schedules

The sleep pattern is also known to change in Bipolar disorder. Waking up times become erratic, and can be earlier or later, and the frequency of broken sleep can also increase. 

Co-occurring Drug Addictions

If one has a drug or substance abuse problem, it can affect the sleep that one gets during Bipolar disorder. It can make the individual even more sleepy or less sleepy than they are already. 

Co-occurring Sleep Apnea

Many individuals with bipolar disorder also have sleep apnea, a serious condition in which breathing is interrupted. This can lead to sleepiness and not feeling well-rested.

Mood Instability

Due to the very nature of the disorder, the mood fluctuates and can go back and forth—quickly that too, unprecedented and without warning as well. Mood states can shift very quickly, from a manic kind to a depressive kind.

Physical and Emotional Toll of Insufficient Sleep

One can feel psychosomatic conditions wherein the body starts showing physical symptoms that are actually caused by psychological problems, such as Bipolar disorder. The emotional toll is also that the mood state will keep changing, so it canquickly become very chaotic. 

Cognitive Impacts of Sleep Shortage

Cognitive impairment is often experienced by people with Bipolar disorders, and even major depressive disorder is associated with impaired psychosocial function and poorer quality of life.

Treating Insomnia and Other Sleep Issues in Bipolar Disorder

Treatment for insomnia and other sleep issues in Bipolar disorder usually consists of medication, psychotherapy or some sort, lifestyle changes, getting into relaxation techniques, and having a good support system. 

Medication Management

The psychiatrist is very likely to prescribe some sort of medication usually consisting of mood stabilizers and sleep aids, in treating sleep issues associated with Bipolar disorder, which in turn helps control the symptoms of the disorder itself. 

Behavioural Therapies

Cognitive-behavioural therapy for insomnia (CBT-I) and other behavioural strategies are often prescribed to improve sleep patterns—as well as manage the symptoms of Bipolar disorder on the whole. Other therapies that may be recommended are interpersonal therapy and also social rhythm therapy.

Lifestyle Adjustments

A change in one's lifestyle can help one’s sleep. This can be achieved by having a good diet, avoiding alcohol and caffeine before bed, exercising and going to sleep at a regular time will be helpful in managing one’s sleep issues. 

Integrating Mindfulness and Relaxation Techniques

Mindfulness techniques, and self-care at the end of the day can really be very helpful to getting a good night’s sleep. A nighttime routine to wind down, and meditation at the end of the day will certainly be able to help you fall asleep. 

Importance of Family Involvement in Sleep Regulation

The family members can help maintain a routine, pushing the individual to make better choices and decisions. Having the right kind of family support can make a great impact on one’s sleep regulation. 

Ways to Get Better Sleep with Bipolar Disorder

There are certain steps one can take to get better sleep even with bipolar disorder, such as:

Prioritising Sleep

A consistent sleep schedule, wherein one goes to bed and wakes up at the same time, is good to maintain. Performing some routines of self-care which can help you wind down before bed are also found to be helpful. 

Developing a Bedtime Routine

Make the bedroom a place where one can relax. Let it be dark and quiet so that one can use the room primarily for sleep—and not anything else. 

Creating a Restful Bedroom Environment

If one enjoys some white noise, make sure that is arranged for. Make sure the room is as dark as it can be, with no distracting noises or light sources around. 

Reducing Sleep Interferences

Avoid using electronic devices before bedtime. The blue light can interfere with the circadian rhythm of the body, and distract one before one needs to be asleep. Block out noises if any, before going to sleep to ensure a peaceful night of sleep. 

Eliminate Alcohol and Caffeine

Both alcohol and caffeine are best avoided, especially towards the end of the day, as they can leave you feeling stimulated at the end of the day, several hours after consumption.  

Staying Active During the Day

Sunlight and physical activity throughout the day may help you avoid daytime sleeping and feel more tired at night.

The Importance of Family Involvement in Sleep Regulation

Having the right kind of family support can make a great impact on one’s sleep regulation. The family members can help maintain a routine, to be able to push the individual to make better choices and decisions. 

Embracing Restful Nights: A Cadabams Approach

We at Cadabams believe in putting one’s mental health first. We have state-of-the-art technology and infrastructure and a great team of trained professionals who are very well-equipped to deal with cases related to sleep and Bipolar disorder. We believe in getting the help that one needs, and one deserves to get help when one needs it. 


1. Can sleep deprivation trigger a manic episode in bipolar disorder?

It can. Lack of sleep and dysregulated sleep can definitely trigger a manic episode. It is essential that one gets a good night’s worth of sleep when diagnosed with Bipolar disorder. 

2. Can bipolar disorder cause sleep problems?

Some potential sleep disturbances linked to bipolar disorder are:

  • A decreased need for sleep, often associated with episodes of mania
  • Trouble falling asleep, also known as having a longer sleep onset latency. This is a key feature of insomnia.
  • Difficulty staying asleep throughout the night. This is another key feature of insomnia.
  • Waking too early
  • Sleeping too much, also known as hypersomnia, either during the day or for prolonged periods at night
  • Reduced sleep efficiency

3. How can I improve my sleep if I have bipolar disorder?

Things such as cognitive behavioural therapy (CBT), interpersonal and social rhythm therapy (IPSRT), family therapy and psychoeducation are immensely helpful in regulating one’s sleep  when diagnosed with Bipolar disorder. One may even be recommended medical sleep aids as well. 

4. What is the connection between sleep and mood episodes in bipolar disorder?

Sleep disturbance is a core symptom of bipolar disorder. The diagnostic criteria indicate that during manic episodes there may be a reduced need for sleep and during episodes of depression, insomnia or hypersomnia can be experienced nearly every day.

5. What are some effective treatments for sleep disturbances in bipolar disorder?

Some of the treatments include cognitive behavioural therapy (CBT), interpersonal and social rhythm therapy (IPSRT), family therapy and psychoeducation. One may even be recommended medical sleep aids. 

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