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Insomnia and Bipolar Disorder

People with bipolar disorder often have problems with sleeping. During manic phases, some people will go without sleep for days without feeling tired. During depression people may also suffer from insomnia. Those with bipolar disorder may have problems sleeping between episodes as well. Even medications for bipolar disorder may cause sleep problems. The body needs a regular amount of sleep in order to function properly and suffering from insomnia can have a huge effect on people with bipolar disorder.

Insomnia happens when a person has difficulty with falling asleep and/or staying asleep. There are two types of insomnia- acute and chronic. Acute insomnia can last one night to several weeks. Chronic insomnia occurs when a person has trouble sleeping for at least three nights a week for a minimum of one month.

Symptoms of insomnia include:

  • Problems falling asleep
  • Problems staying asleep
  • Waking up earlier than normal
  • Feeling tired upon waking
  • Daytime sleepiness
  • Irritability, depression or anxiety
  • Problems with concentration, attention and memory
  • Worrying about sleep

Insomnia can have other negative effects. Lack of sleep can impair judgement. People with bipolar disorder already have problems with risk-taking behavior. Not sleeping can make that worse. Insomnia also leads to more accidents in situations where a sleep-deprived person chooses to drive or operate machinery.

Sleep deprivation can make bipolar disorder worse in other ways as well. It acts in a cyclical manner. Lack of sleep can cause depressive symptoms and depressive symptoms can make it difficult to fall asleep and stay asleep. Insomnia can also exacerbate problems with cognitive functioning areas like attention, memory, concentration and critical thinking. Up to 60% of people with bipolar disorder already have problems with cognitive function even without sleep problems.

Insomnia may be able to help predict the onset of bipolar disorder episodes. Trouble sleeping may be the first sign of an oncoming manic episode, especially if the lack of sleep does not lead to feeling tired. Depression can also cause insomnia, so trouble with falling asleep or having fragmented sleep followed by signs of tiredness and cognitive deficit could predict a depressive episode.

There are a few ways to help treat insomnia:

  • Having healthy sleeping habits like going to bed and waking up at the same time every day, sleeping in a cool, dark room and avoiding caffeine and screens the few hours before bed.
  • Cognitive behavioral therapy can help ease other psychological symptoms of bipolar disorder as well as general life stress, possibly making sleep easier.
  • Medications like prescription sleep aids, benzodiazepines or adjustments in bipolar disorder medications can help in the more severe cases of insomnia.
  • Medical devices like CPAP machines may be necessary if insomnia is caused by conditions like sleep apnea as opposed to purely psychological stressors.

It’s important to track symptoms of insomnia and speak to a doctor in case changes in lifestyle or treatment need to be made. Solving insomnia may be as simple as changing sleeping patterns or changing medication, but providing a doctor with the relevant information is crucial in finding both the cause of insomnia as well as the solution.



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Image credit: Mateus Lunardi

Insomnia and Bipolar Disorder

LaRae LaBouff

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APA Reference
LaBouff, L. (2017). Insomnia and Bipolar Disorder. Psych Central. Retrieved on June 5, 2020, from


Last updated: 21 Nov 2017
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