Bipolar disorder, by definition, comes with sleep problems. Everyone’s body has internal clock that regulates not only sleep habits, but also hunger and thirst. This is your circadian rhythm. Its what makes you wake up during the day, fall asleep at night and nourish yourself in between. In bipolar disorder, this rhythm is disrupted. The body does not keep up with the sleep/wake cycle, causing sleepless nights and tired days. Far from I just didnt sleep well, here are five sleep issues that are more common when you have bipolar disorder.

1 SleeplessnessGoing without sleep is a primary symptom of a manic episode. During these times, patients will survive on only a few hours of sleep or not sleep at all for several days. You would imagine that doing so would create a zombie, shambling from task to task just craving some shuteye. On the contrary, energy levels stay high as though sleeplessness isnt even an issue. It might sound great, but people need sleep. Going without it is dangerous, and can even be deadly.

2 InsomniaThough they sound similar, insomnia and sleeplessness are not the same. Sleeplessness during mania is often seen by the patient as advantageous- more time to do more things. Insomnia, on the other hand, is when you want to sleep and are trying to sleep, but are unsuccessful. Think of the times youve laid awake thinking If I fall asleep now, I can still get (so many) hours of sleep. Thats insomnia, and with bipolar disorder, it can happen almost every night during a depressive episode.

3 Daytime sleepinessYoure falling asleep at your desk despite having slept well the night before. Youve tried caffeine, but now youre just jittery on top of being tired. This is daytime sleepiness. People with bipolar disorder are more than twice as likely to experience it than the general population. When depressed, your body can default to sleeping too much instead of sleeping too little. However, 40% of bipolar disorder patients report having problems with tiredness even between episodes.

4 Night terrorsThough not uncommon in childhood, most people grow out of having night terrors. For bipolar disorder, that doesnt seem to be the case. About 10% of adults with bipolar disorder experience the sweating, screaming, intense fear, rapid breathing and body flailing that come along with night terrors. Even if these physical symptoms arent present, its still incredibly common for people with bipolar disorder to have nightmares.

5 SleepwalkingWalking through hallways with your arms outstretched is a bit of a trope. With sleepwalking, people engage in all sorts of activities ranging from just sitting up in bed to getting up and leaving the house with no awareness of their actions. Again, its more common in children, but around 2% of the adult population experience it as well. That number goes up to around 9% when dealing with bipolar disorder.

There are a few reasons these sleep disturbances are more common in people with bipolar disorder. They could be an innate part of the disorder, a result of circadian dysrhythmia or side effects from medication taken for either bipolar disorder itself or for medications prescribed to combat sleep issues.

Either way, the best ways to keep sleep disturbances at bay are to eat well, keep a daily routine, take medications as prescribed and practice good sleep hygiene.

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