What is the Relationship Between Bipolar Disorder and Sleep?
Bipolar disorder and sleep have a multifaceted relationship. Changes to sleep patterns are extremely common for people with bipolar disorder and can include both insomnia and hypersomnia. In addition, mounting evidence points to sleep disturbances as being a contributing factor that can worsen symptoms of bipolar disorder or cause it to recur after a period of remission.
The following sections explain in further detail the way that bipolar disorder impacts sleep and how sleep problems influence the condition’s development.
How Does Bipolar Disorder Impact Sleep?
Disturbed or altered sleep is common in patients with bipolar disorder. Changes to sleep patterns can occur during both manic and depressed episodes.
During manic episodes, people with bipolar disorder feel a dramatic reduction in the need to sleep. With enhanced energy and mood, somewhere between 69% and 99% of patients in manic episodes indicate that they feel a decreased need for sleep.
HYPERSOMNIA
When depressed, patients with bipolar disorder frequently sleep too much (hypersomnia). This can relate to a lack of energy and decreased interest in normally enjoyable activities, both of which are common depression symptoms. Hypersomnia is estimated to affect 38% to 78% of bipolar patients. Insomnia can also happen during episodes of depression, and in general, sleep can become disordered and inconsistent.
MANIC PSYCHOSIS
Manic psychosis is an especially intense episode of mania. It can involve hallucinations, delusions of grandeur, paranoid delusions, and extreme increases in activity levels. Manic psychosis can resemble schizophrenia. This state can devolve to delirious mania in which a person’s speech and actions are highly unpredictable and irrational. Hospitalization is usually required during manic psychosis. during periods of remission, when a person is not in a manic or depressed condition, sleep disturbances are common. One study found that 70% of people with bipolar disorder still have significant sleep disturbances during this period.
Sleeping problems are not just limited to too much or too little sleep. People with bipolar disorder frequently have low-quality sleep, inconsistency in their sleep from one night to the next, and problems getting to sleep. The nature of a person’s sleeping difficulties can shift significantly with time, the patient’s mood, and their response to medications.
Another cause of sleep disruption is obstructive sleep apnea (OSA), a condition in which a person’s breathing stops temporarily at different points through the night. One study has found that nearly 25% of people with bipolar disorder have OSA, which can cause marked reductions in sleep quantity and quality. OSA has been linked to a host of other health problems as well, including depression and cardiovascular problems.
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