Bipolar Disorder: Seasons and Sleep

Bipolar disorder (BD) can make you feel jittery and ultra-creative one day and send you plummeting into unrelenting sleepiness and fatigue the next. (1) These sharp swings can often match up with the seasons. Dark, dreary winter months might nudge you into a depressive stage, while the longer, sunnier days of spring and summer can bring on manic episodes, or “spring mania.” You can’t do much about the weather or season changes, but you can do a lot to improve your sleep if you have bipolar disorder.

Note: The content on Sleepopolis is meant to be informative in nature, but it shouldn’t be taken as medical advice, and it shouldn’t take the place of medical advice and supervision from a trained professional. If you feel your child may be suffering from any sleep disorder or medical condition, please see your healthcare provider immediately.

How Bipolar Disorder Affects Sleep

Bipolar disorder can have quite the impact on sleep — both the amount and quality. “Those diagnosed with BD may experience insomnia, hypersomnia, excessive daytime sleepiness, and a reduced need for sleep,” says Dr. Shelby Harris, MD and director of sleep health at Sleepopolis. “Sleep is especially important for people with bipolar disorder, as sleep problems can trigger mood episodes and worsen other symptoms.”

Common Bipolar Sleeping Issues

Different sleeping issues can appear during the manic and depressive stages of BD. For example, insomnia and hypersomnia tend to be depressive stage issues, whereas mania more often results in a decreased need for sleep. (2) Unfortunately, just because you feel rested after a few hours of shuteye, that doesn’t mean your body has done all the resting and restoring it needs to in the abbreviated sleep session.

Other common sleep issues experienced with bipolar disorder include: (3)

• Delayed Sleep Phase Syndrome: can affect your circadian rhythm (internal clock) and make you more sensitive to evening light. Whereas many people can get used to falling asleep while it’s still light out, people with bipolar may have a harder time adjusting to the long summer days.
• Co-occurring Sleep Apnea: pauses your breathing on and off all night. (2)

Manic Phase Sleep

In a manic phase, those with bipolar disorder may find they don’t need as much sleep to feel rested. “The most common disturbance of sleep in a manic episode is what is called a ‘reduced need for sleep,’” says Dr. Bruce Bassi, MD.

This decreased need for sleep differs from insomnia — with insomnia, you feel tired and want to sleep, but with a decreased need for sleep, you are more energized and don’t want to take the time to snooze, Bassi says. (6) (1)

Rikki Lee Travolta, a mental illness advocate who lives with bipolar disorder, tells Sleepopolis that during a manic phase, he can go days without sleeping. “I now take trazodone as part of my treatment,” Travolta says, “but even with that medication, I’m usually up at 2 or 3 a.m.”

Depressive Phase Sleep

When you’re in a depressive phase of BD, you may find you can’t get enough sleep, or that you want to sleep all day and night, which is called hypersomnia. Even though you feel sleepy all the time, you may also deal with insomnia: the inability to fall and stay asleep.

During a depressive phase, Travolta says it’s hard to get enough sleep or get out of bed for basic self-care. “That might not happen until one or two in the afternoon,” he says, “and that might be the only time you get out of bed because you’re right back sleeping again.”

It’s easy to beat yourself up about not accomplishing anything all day, Travolta says, which can lead to more depression and sleep — a cycle that’s hard to break. “If I had my choice, if I had to choose between depression sleep or mania lack of sleep, I would side with the mania because at least I get things done,” says Travolta. Despite the challenges, he says he tries to look at the positive side of everything, and is thankful for the extra time he gets in the day.

Bipolar Disorder and the Seasons

Anyone can get the winter blues, but how does the change in seasons affect someone with bipolar disorder? “Seasonal temperature changes can affect those with bipolar disorder by disrupting sleep, causing stress, and changing routines,” says Harris. “Some people with BD find that their symptoms are worse during certain seasons, such as the summer or winter.”

How Changing Temperatures Affect Bipolar Disorder

Travolta has seasonal affective disorder (SAD), which is a subtype of depression and bipolar disorder that rears its head as the seasons shift. (4) “I respond heavily to season changes,” he says. “Winters are really, really hard for me. Any kind of weather that is dark, dreary, cold…those all have a resounding effect on my mood and on my sleep.”

While some — like Travolta — dread cool, dark weather, other people with bipolar disorder have stronger feelings about summer heat. (5) For some with BD, experts have found that high temperatures can trigger relapses in the disorder. (6)

Rising and falling temperatures aren’t the only factors that affect bipolar disorder. In the fall and winter, less natural sunlight shines during the day, and those with bipolar disorder may be more likely to experience depressive symptoms with the season changes. (4)

Spring and Summer Mania

On the flip side, spring and summer can be common triggers for mania, and being exposed to too much sunlight can increase the risk of manic episodes. Sometimes called spring and summer mania, or “spring fever,” this increase in manic behavior is often blamed on more sunshine. (6)

Bipolar disorder is cyclical by nature: it causes swings back and forth between mania and depression and, for some, these cycles can sync up with seasonal changes. (1) (6) The stress and excitement of all the activity warmer weather brings can also trigger manic episodes — stress releases hormones like adrenaline, which can get anyone amped up, but can push people with BD into mania. (7)

All this excitement can make it difficult to fall asleep, and for many with BD, like Travolta, anything that causes a manic episode can lead to a lower need or desire for sleep. (2)

Getting Better Sleep with Bipolar Disorder

Sleep is essential no matter what kind of medical or mental health situation you’re working with. When you sleep, your brain consolidates memories, your body rests, and important physiological processes take place. (8) If you have bipolar disorder, the following ideas can help you snag some more zzzs.

Use Good Sleep Hygiene

Sleep hygiene involves making sure your habits around bedtime are consistent and conducive to sleep. “People with bipolar disorder can get better sleep by sticking to a regular sleep schedule, creating a relaxing bedtime routine, increasing exposure to natural light during the day, and avoiding caffeine and alcohol before bed,” says Harris. (9)

Keeping a regular schedule for bedtime and wake-up will help your body get into gear. “Do whatever is necessary to go to bed and wake up at the same exact time, regardless of the day of the week or how poorly you slept,” says Bassi.

This might be easier said than done — sometimes life happens, after all — but Bassi offers a tip to help anyone looking to try. “To get to bed at the same time, sometimes I recommend setting a night alarm to help remind people to start unwinding.” At the very least, you won’t find yourself scrolling through social media or binge watching the newest show without realizing your bedtime has long passed.

You can also improve your sleep hygiene by avoiding big meals before bed, keeping your bedroom cool and dark, avoiding screens before bed, and getting exercise during the day. (9)

Try Cognitive Behavioral Therapy for Insomnia (CBT-I)

Cognitive behavioral therapy for insomnia (CBT-I) is the first choice of treatment for those who have trouble falling asleep and staying asleep. This therapy, performed by a licensed professional, identifies thought patterns that could be holding you back from a good night’s rest. (10)

Experts have found that CBT-I can improve sleep quality and quantity for some with bipolar disorder. (10) This therapy makes your sleeping hours more consistent, which in turn improves memory and comprehension. (2)

See Your Healthcare Provider

Sometimes, excellent sleep hygiene and behavioral techniques still aren’t enough to help you get the sleep you need, especially during a manic episode. “If you are still having trouble sleeping, talk to your doctor, therapist, or sleep specialist,” says Harris. Your provider can help you figure out if anything else is going on (like another sleep disorder).

For someone with BD with a reduced need for sleep, medication may be needed, says Bassi. Travolta says trazodone doesn’t fix all his sleep problems, but it helps. “It at least gives me those four or five hours…or three,” he says. “But it’s all better than nothing.”

The Last Word From Sleepopolis

If you have bipolar disorder and heading into a new season makes you dread a change in your sleep, know that you have options. Whether sticking to a strict sleep schedule helps you, or you need advice from your provider, you can use all the techniques above to make sure you get the rest you need.

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