The connection between bipolar disorder and sleep is nothing new. When I was first diagnosed with bipolar disorder my doctor mentioned how important it was to establish a regular sleeping routine. Throughout my life, I have been researching the connection and concluded, sleep disturbances in people with bipolar disorder are present from the beginning. This connection between bipolar and sleep can have a negative impact on your quality of life, and treatment outcomes.
Last week on my Facebook page, I made a post asking people for content idea’s, and the type of content they would like to read. One topic which came up several times was – bipolar and sleep deprivation. So, I’ve put together this content to help you understand the connection between the two.
Role of Sleep in Regulating Mood
Sleep regulates the neurotransmitters – serotonin, dopamine, GABA, and norepinephrine. In fact, serotonin directly regulates mood so lack of sleep will affect your overall mood.
“Three brain chemicals — noradrenaline (norepinephrine), serotonin, and dopamine — are involved in both brain and bodily functions. Noradrenaline and serotonin have been consistently linked to psychiatric mood disorders such as depression and bipolar disorder.” – webmd.com
Bipolar Disorder and Sleep Disturbances
Studies have shown a lot of people having sleep issues when they are bipolar. This has a negative impact on their lives, and even on their treatment. Sleep, either too much or too little, can be associated with mania and/or depression. For example, two important statistics did pop-up during my research –
“During mania or hypomania, sleep disruptions are commonly presented as a reduced need for sleep with studies finding that 69%–99% of bipolar individuals report a lessened need for sleep during a manic episode or difficulties in falling and/or staying asleep.” Next,
“During depression, sleep disruptions are commonly exhibited as hypersomnia or excessive sleepiness”
We know people with bipolar disorder do experience sleeping problems, and evidence shows during a manic or depressive episode sleep is affected. But, it’s important to understand why sleep is the area MOST affected in people with bipolar disorder. It’s equally important to understand the role of sleep disturbances in bipolar episode relapse.
Here’s the thing, before jumping into the next section, it’s important to mention that –
“A widely accepted explanation for sleep disturbances in bipolar disorder rests on a circadian system model, which posits that sleep problems among bipolar patients result from dysregulated circadian rhythms”
Here’s this in simpler terms…
What Is Circadian Rhythm?
This is our bodies internal 24-hour clock system. This rhythm keeps our bodies in sync with the 24-hour clock and gives different parts of our bodies signals to start stop different functions like – digestion, repair, body temperature, and the release of hormones. One of the most important functions is to tell your mind when to feel alert and when to feel sleepy.
Bipolar Disorder and Effect on Circadian Rhythm
Researchers have been working hard to understand the role of circadian rhythm in people with bipolar. Here’s what they have found –
They have determined people with bipolar disorder have a non-adaptive circadian system. Non-adaptive means a system which is “dysfunctional” and the sleep-wake cycle pattern is entrained. Research also shows how this dysfunctional circadian system leads to mood episodes and negatively impacts their internal clock for sleep, meal, hormone release, and digestion. Many believe this is why people with bipolar disorder put on excessive weight when taking medication.
“According to a circadian rhythm disruption model of bipolar disorder, abnormal circadian rhythms interact with various competing social zeitgebers (a cue given by the environment, such as a change in light or temperature, to reset the internal body clock), leading to mania (characterized by behavioral activation) or depression (characterized by behavioral inhibition).”
The circadian rhythm system (internal 24-hour clock) is responsible for releasing Melatonin into your system. Its secretion is regulated by a circadian rhythm-generating system located in the suprachiasmatic nucleus of the hypothalamus, which is in turn regulated by light. The levels of Melatonin will rise during the evening and lower at night making you sleepy, and decrease during the day to keep you awake.
For me, it’s all beginning to make sense,
People living with bipolar disorder already have dysfunctional circadian rhythm system. With an unregulated internal clock, the bodies circadian rhythm has a hard time distinguishing your sleep-wake cycle. This means the levels of Melatonin are not normal. Remember, for people without bipolar disorder these levels go up at night to help you sleep, but during the day are very low to keep you awake. But, people who have bipolar disorder have internal clocks out of sync meaning the Melatonin levels are unstable making it hard for you to sleep and/or stay awake.
With a poor sleep wake cycle, people with bipolar may experience mania or depression.
I’ve known the importance of sleep ever since I was diagnosed with bipolar disorder. My doctor made it a point to tell me to work on my sleeping pattern because it will help regulate my mood. I’ve also noticed when my sleep was disturbed for a few days it would negatively impact my mood. One of the most important factors in helping me control my mood has been a fixed sleeping pattern.
Your bodies circadian rhythm can be disrupted by social events which happen or are happening in your life. This internal clock regulates the release of Melatonin in your body helping you sleep at night, and stay awake during the day. People living with bipolar disorder have a dysfunctional circadian rhythm system un-regulating the release of Melatonin in our systems. This disrupts sleep and negatively impacts our mood.
The good news is that it’s never too late to adjust your sleeping habits. Furthermore your circadian rhythm system. Here are a few pointers –
Sleep at the same time every day – choose a time suitable for you and stick to it. You’ll develop a sleeping pattern your mind is used to and will start to get tired around the same time every day. You don’t need to be in bed extra early but anytime you feel comfortable. The key is to stick to this schedule.
Stay Away from Caffeine – caffeine is a stimulant and keeps the mind awake. Here’s something I read –
“most people use it after waking up in the morning or to remain alert during the day. While it is important to note that caffeine cannot replace sleep, it can temporarily make us feel more alert by blocking sleep-inducing chemicals in the brain and increasing adrenaline production.”- sleepfoundation.org
Shut off Computer or Bright Lights – I stop using the computer two hours before going to bed. When I would be on the computer too close to bed, it would keep my mind alert making it impossible for me to sleep.
“Bright light in our environment can signal our brains to stay alert and we get a direct dose of it by looking at a phone or computer. “- cnet.com
Read a Book – make sure this is not on your phone, but an actual book. This slows down your mind calming it down. With a calmer mind, you’ll feel more relaxed ready to go to sleep.
What strategies do you use to help you sleep at night? What are your thoughts on the rest of the content? 🙂