This article is Part II of “Sensory Processing & Sleep Quality in Bipolar Disorder.” You can read part I here.
Sleep problems are one of the main symptoms of bipolar disorder. In addition to either insomnia or hypersomnia in depression and a feeling of needing to sleep less in mania, there are other sleep problems associated with bipolar disorder. These include daytime sleepiness, night terrors and sleepwalking. There are a few reasons why this is the case. One of the predictors of sleep patterns in bipolar disorder may be how the person perceives sensory input.
Up to 35% of people with bipolar disorder experience hypersensitivity, especially when associated with longer episodes. This is when people are extra sensitive to stimuli like lights and sounds. Around 28% of people with bipolar disorder experience hyposensitivity, which takes more stimulation to affect the person.
How a person perceives sensations may also affect how well they sleep. There are five indicators of a person’s overall sleep quality:
- Sleep disturbances involve problems initiating and maintaining sleep.
- Sleep duration is the total amount of sleep in a night.
- Sleep latency is how long it takes to initially fall asleep.
- Daytime dysfunction is sleepiness during the day or mood/motor problems associated with sleepiness.
- Sleep efficiency is the total time in bed spent actually sleeping.
A recent study published in the Journal of Psychiatric Practice and led by Batya Engel-Yeger looked at the sleep patterns of 176 people with either unipolar or bipolar affective disorders. They found that sleep quality may depend on whether a person is hyper- or hyposensitive.
For hyposensitive participants, they found that they had problems with sleep disturbances and sleep duration, leading to poorer overall sleep quality. This may also reflect problems seen with sleep in mania. During manic episodes, people with bipolar disorder tend to sleep significantly less without feeling tired.
Those with hypersensitivity experienced problems with all five indicators, with worse overall sleep quality. The authors of the study postulate that the poor sleep quality experienced by those with hypersensitivity may be correlated with depression and anxiety. Insomnia is common in depressive episodes of bipolar disorder. Insomnia could cause all of these issues with sleep quality. It can even occur prior to depressive episodes.
Tracking sleep quality is one way people with bipolar disorder can predict upcoming episodes and prepare for them, whether it is noticing a lack of need for sleep or attempting sleep and finding oneself unable to do so well.
Sleep has a major impact on quality of life. Without it, the brain can actually lose neurons. Lack of sleep can also cause problems with cognitive functions like memory, attention, decision making and critical thinking. It can affect metabolism and immune function. Perhaps knowing whether or not a person experiences hypo- or hypersensitivity can help determine where sleep problems occur and how they may be able to receive treatment.
Image credit: Mateus Lunardi Dutra