Bipolar disorder is a mental health condition that affects mood and can cause periods of elation and depression. People with bipolar disorder commonly experience sleep disturbances, which may result in excessive sleepiness.

Bipolar disorder is a mental health condition that can cause extreme shifts in mood, energy, activity level, concentration, and ability to perform everyday tasks.

Bipolar disorder has different types that vary in severity and symptom duration. Additionally, sleep problems are a common symptom of the condition and may cause a person to experience excessive sleepiness, which is also known as hypersomnia.

This article will discuss the relationship between bipolar disorder and sleep, including how a person can improve their sleep.

A person with bipolar disorder sleeping with a pillow on their head, representing oversleeping.Share on Pinterest
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The National Alliance on Mental Illness describes bipolar disorder as a mental health condition that causes extreme shifts in a person’s mood and energy.

Someone living with bipolar disorder experiences mood episodes, which can include periods of high mood (mania) and depressive states of feeling low.

There are three main types of bipolar disorder:

  • Type 1: In this type, a person experiences one or more episodes of mania. They may or may not experience episodes of depression, but these are not necessary for a diagnosis.
  • Type 2: This type involves episodes of both depression and hypomania, a milder and shorter form of mania.
  • Cyclothymia: This condition involves less intense changes in mood. A person may experience periods of mild depressive symptoms and periods of mild mania.

Learn more about the different types of bipolar disorder.

A 2022 study notes that sleep disturbance is a common symptom of bipolar disorder. Additionally, a 2019 review states that sleep disturbances are often a good predictor of mood swings in people with bipolar disorder.

Bipolar disorder may affect sleep in several ways:

  • Insomnia: A person may have difficulty falling asleep or staying asleep.
  • Hypersomnia: A person may experience excessive sleepiness during the day.
  • Irregular sleep-wake schedule: A person may lack a sleep routine and experience an irregular sleep cycle.

A person with bipolar disorder may also experience sleep abnormalities that are not necessarily disorders. For example, they may feel a decreased need for sleep during episodes of mania and need more sleep during periods of depression.

Hypersomnia is a sleep disorder in which a person feels excessively sleepy during the day and may have prolonged periods of nighttime sleep.

It differs from tiredness due to insufficient or interrupted sleep and may cause a person to nap at inappropriate times during the day, such as at school or work.

Learn more about sleep deprivation.

Research suggests that hypersomnia is highly prevalent in bipolar disorder, and older studies have noted occurrence rates of 38–78%.

Sleep disturbances can persist across all phases of the condition and may worsen symptoms. However, a person with bipolar disorder is more likely to experience hypersomnia during a depressive episode.

Health experts divide hypersomnia into two distinct types: primary and secondary hypersomnia.

Primary hypersomnia occurs when no other medical condition is present, and excessive daytime sleepiness is the only symptom. Secondary hypersomnia occurs when an underlying medical condition causes fatigue or insufficient sleep.

Learn about the differences between hypersomnia and narcolepsy.

Some evidence suggests that multiple biological factors could contribute to the relationship between bipolar disorder and hypersomnia.

For example, a 2022 literature review notes that a potential link between bipolar disorder and a disruption of circadian rhythm could explain the changes in sleep.

While secondary hypersomnia may arise in bipolar disorder, researchers do not know whether there is a directional relationship between the two conditions. More research is still necessary to understand the relationship between bipolar disorder and sleep disturbances.

To improve sleep, the Centers for Disease Control and Prevention (CDC) suggest developing good sleep habits, which health experts call good sleep hygiene. These include:

  • Setting a sleep schedule: A person should go to bed at the same time each night and wake up at the same time each morning.
  • Improving the sleep environment: A person should ensure that the bedroom is quiet, dark, and comfortable whenever possible. They should also use their bedroom only to sleep.
  • Staying off devices: People should remove electronics such as TVs and computers from their bedrooms.
  • Being mindful of food and drink intake: People should avoid consuming heavy or large meals, caffeine, and alcohol too close to bedtime.
  • Exercising regularly: Exercising during the day may help a person fall asleep more easily.

Click here to learn more about sleep hygiene.

A diagnosis of hypersomnia will involve a doctor reviewing a person’s medical history and symptoms. To help diagnose and rule out other sleep disorders, a healthcare professional may also order tests that monitor and measure sleep.

These may include:

  • Sleep log: Also known as a sleep diary, this is a detailed record of a person’s sleep patterns for at least 2 weeks.
  • Epworth Sleepiness Scale (ESS): This questionnaire asks a person to rate how likely they are to fall asleep during common daytime situations, such as while watching television. Scores can range from 0–24, and higher overall scores indicate a higher level of excessive sleepiness.
  • Polysomnography: Also known as a sleep study, this test uses electrodes and devices to measure an array of bodily functions while a person is sleeping. This can help rule out several sleep disorders that could be responsible for a person’s sleepiness.
  • Actigraphy: This involves a watch-like device that a person wears on their nondominant wrist. It records movements to measure their sleep-wake cycle. A doctor may use this to confirm the information in a sleep log.

Sometimes, a doctor may also order laboratory tests to help diagnose hypersomnia. For example, they may recommend a blood or urine test to check for nutrient and hormonal deficiencies or substance use that may be causing sleepiness.

The first-line treatment for hypersomnia is the stimulant modafinil (Provigil). Other stimulants a doctor may prescribe include amphetamine (Adderall) and methylphenidate (Ritalin and many others).

But stimulants may not work for a person with a mood condition such as bipolar disorder. In this case, a doctor may try antidepressants instead.

There can be other cases in which stimulants alone are not enough. A doctor will need to diagnose and treat the underlying cause.

It may also be advisable for people to make certain lifestyle changes, such as avoiding night work or activities that may delay bedtime and changing dietary habits to avoid alcohol and caffeine.

Treatment plans for bipolar disorder typically involve a combination of medication and psychotherapy.

A person can consider contacting a healthcare professional if they feel that excessive daytime sleepiness is beginning to negatively affect their daily functioning.

Additionally, if someone with bipolar disorder notices severe changes in their mood or if other symptoms are starting to disrupt their daily activities, it is advisable that they seek medical help.

How many hours should a bipolar person sleep?

People should try to sleep at least 7 hours per night, regardless of whether they have a condition such as bipolar disorder. Sleeping less than this increases the chances of developing various health problems, according to the CDC and the American Academy of Sleep Medicine.

Why are bipolar people so tired?

People living with bipolar disorder fluctuate between periods of mania and depression. This in itself can be tiring. In addition, depression can cause a person to experience sleep problems, which can add to fatigue.

What are maladaptive behaviors in bipolar disorder?

Maladaptive behaviors are any behaviors a person might use as coping mechanisms that actually negatively affect their ability to live a healthy life.

In bipolar disorder, these can include:

  • excessive rumination or overthinking
  • catastrophizing
  • self-criticism
  • substance misuse
  • taking unnecessary risks
  • negativity

Bipolar disorder is a mental health condition that can affect a person’s energy levels and sleep patterns. Many people with bipolar disorder may experience excessive daytime sleepiness, or hypersomnia.

Researchers are still unsure of the exact cause of hypersomnia in people with bipolar disorder.

A doctor will often prescribe medication and suggest lifestyle strategies to address this sleep disturbance.