By Stephen Propst
Those ever-important nighttime hours are vital to mood stability with bipolar disorder. Here are my tips on getting much-needed shut-eye.
Disturbed Sleep & Bipolar Disorder
Do you have something in life you would like to leave behind, but life events continue to trigger a return to that horrible place? My senior year in college is burned in my memory like a memorial alongside a road where a tragic accident occurred. During that year, I had my first battle with bipolar depression, which lasted nine months, followed by three months of full-blown mania. Unfortunately, as so often happens, years of suffering passed before bipolar disorder was correctly diagnosed and treatment started.
One of the hallmarks of that period in my life, and a challenge I continue to face to this day, was a profound change in the quality of my sleep. Disturbed sleep became as problematic as the mood disorder itself.
During my first depressive phase—nine months of an unrelenting state of gloom and desperation—I slept up to 18 hours a day. But, because the sleep was so troubled, I would awaken exhausted and unable to concentrate. When my mood shifted to a manic phase, my sleep pattern shifted as well. I slept a meager two to three hours per night at most, and then awoke full of chaotic, unfocused, manic energy.
Even today, good, sound, natural sleep is a cherished and sometimes difficult achievement. In fact, several years ago, no doubt due to sleep deprivation, I fell asleep while driving and totaled my car. What a wake-up call that was! I knew then that I had to start taking sleep seriously.
Indeed, sound sleep is a serious matter for all of us. So, I want to give you something to sleep on, besides, of course, a good mattress. Let’s study the issue of sleep by asking four important questions.
Question 1: How much sleep do we need?
Quality sleep is important to your productivity, safety, and overall health. Yet, sleep disorders are widespread in the United States. About 75 percent of Americans do not get adequate nightly sleep, and 51 percent report having sleeping difficulties at least a few nights per week (National Sleep Foundation poll). Sleep deprivation costs an estimated $150 billion each year in increased stress and lower worker productivity (National Commission on Sleep Disorders).
The amount of sleep a person needs depends on several factors, including age. Seven to eight hours per night is generally recommended by sleep experts as being the best amount of sleep for most adults, but individual requirements can range from 5 to 10 hours. When anyone is deprived of quality sleep, a “sleep debt” is created, similar to being overdrawn at a bank. Eventually, the body, like the bank, will demand repayment.
Question 2: What does sleep do for us?
People once thought of sleep as a passive, dormant part of our daily lives. We now understand that quality sleep helps maintain sound physical and mental health. Sleep at night helps repair neurons used during the day, according to studies by sleep experts.
Furthermore, deep sleep really is “beauty sleep” because it slows the breakdown of proteins, the building blocks for cell growth. Sleep helps the body conserve energy and other resources necessary for the immune system to effectively mount its attacks. Moreover, a good night’s sleep also helps ensure a properly functioning nervous system. Poor or inadequate sleep can lead to drowsiness, poor concentration, and impaired memory. (For more details, see “The Quest for Sleep,” by Milly Dawson, Spring 2006, bp Magazine.)
Question 3: What about sleep and bipolar disorder?
The amount of sleep a person gets strongly influences bipolar symptoms. Disrupted sleep can trigger episodes of mania and generate agitation and hyperactivity. Extreme sleep deprivation can even lead to a psychotic state of paranoia or cause hallucinations, both of which are dangerous.
When measured on a driving simulator, sleep-deprived individuals perform as badly or worse than those who are intoxicated. Furthermore, sleep deprivation magnifies the effects of drinking alcohol, which is, unfortunately, commonplace among those who have bipolar disorder, making for an even riskier situation.
Getting solid, deep sleep positively impacts the brain’s capacity to control emotions, handle decision-making processes, and govern social interactions. Yet this type of sleep is often impaired when bipolar disorder is in the picture. If you are dealing with bipolar, it is especially important to make sure that you’re getting the most productive sleep possible. The better you manage your sleep, the more able you are to learn to manage your mood.
Question 4: What can you do to improve your sleep?
When sleep troubles persist, taking a sleeping pill does not have to be the first resort. Here are some tips to increase the likelihood of getting a good night’s rest:
#1 Set a schedule
Make sleep a priority. To establish a consistent sleep pattern, try awakening at the same time every day (weekends included). Your bedtime will soon take care of itself based on how much sleep you find yourself needing. Once you’ve fine-tuned your sleep schedule, stick to your ritual to avoid insomnia. Just sleeping in on weekends can reset your sleep cycle and make for problems waking up Monday morning.
#2 Exercise
Try to exercise 20 to 30 minutes a day. Daily exercise often helps people sleep, although a workout soon before bedtime may interfere with sleep. For maximum benefit, try to exercise about five to six hours before going to bed.
#3 Avoid caffeine, nicotine, & alcohol
Consuming stimulants, such as caffeine or chocolate, in the evening can keep you awake. Smoking can lead to a person sleeping lightly and waking up more often during the night. Drinking alcohol near bedtime can interrupt and fragment sleep.
#4 Relax before bed
Try to unwind early and deal with life’s distractions well before bedtime. A warm bath or another peaceful routine can make it easier to fall asleep. Developing a nighttime ritual can signal your body and mind that it’s time to sleep.
#5 Sleep until sunlight
If possible, wake up with the sun, or use very bright lights in the morning. Sunlight helps the body’s internal biological clock to reset itself each day. Sleep experts recommend exposure to an hour of morning sunlight.
#6 Control your bedroom environment
The bedroom should be reserved for only two activities—sleep and … you know what! Other habits, like reading in bed, watching television, or snacking, should be avoided because they shift your mind’s focus away from the goal of sleep. Maintain a comfortable temperature in the bedroom, and make sure that any distracting noise is eliminated. And, don’t forget the importance of a comfortable mattress and bedding.
#7 Don’t lie in bed awake
If you can’t get to sleep, don’t just lie in bed, tossing and turning. The anxiety of being unable to fall asleep can actually contribute to insomnia. It is best if you go to another room and do some calming activity, such as listening to music, until you feel tired enough to go back to bed.
#8 Be aware of the medications you’re taking
If you’re dealing with bipolar disorder, chances are that your doctor may have you taking one or more medications. Some medications may have side effects and cause insomnia or drowsiness. It is essential that you discuss with your doctor your sleep patterns and any changes that occur.
#9 Take additional steps if sleep problems persist
If you have trouble falling asleep night after night, or if you always feel tired the next day, you may benefit from seeing a sleep specialist. In difficult cases a doctor may prescribe a sleep agent or other treatment. Fortunately, most sleep disorders can be treated effectively. Do whatever it takes to get the good night’s sleep that you need.
There is an old joke about a nurse awakening a patient to take a sleeping pill. However, sleeping problems are no joke. Lack of good sleep can cause confusion and frustration during the day and diminish a person’s overall mental alertness and well-being. Better sleep management—especially when someone has bipolar disorder—can dramatically improve health and quality of life. Now, maybe you can sleep on that!
Used by permission.