The Sleep-Symptom Connection in Bipolar

Psychological conditions can be intensified by life stressors, traumatic experiences, and interpersonal conflicts. Lack of sleep can also increase the symptoms of mental health problems. Additionally, sleep problems can indicate the presence of psychological illnesses such as depression and anxiety. Researchers have studied the effects of poor sleep patterns on mental and physical health for many years. But there have been few studies that have focused on how sleep fluctuates during nonsymptomatic periods. For instance, individuals with bipolar experience episodes of positive and negative affect but also go through periods when their moods are relatively stable. Although sleep patterns may be quite volatile in the presence of symptoms, few studies have looked at how interepisode sleep cycles affect symptom severity and the onset of future episodes.

To address this gap in research, Anda Gershon of the Department of Psychiatry and Behavioral Sciences at Stanford University recently conducted a study that examined the sleep patterns of 32 individuals with bipolar for 8 weeks. The participants were classified as interepisode at the time of the study and were assessed daily for affect, symptom severity, and sleep behaviors. Gershon looked specifically at how particular aspects of sleep, such as sleep onset and sleep quality, differed from a sample of 36 individuals with no history of bipolar.

Gershon found that the individuals with bipolar had more sleep disturbances than the controls. The clinical participants had more difficulty falling asleep and woke more during the night. They also stayed awake longer when they woke and had more trouble going back to sleep. The bipolar group demonstrated higher rates of negative affect than the controls. However, when affect was analyzed on the basis of sleep cycles, it was found that sleep impairment led to negative affect equally in both groups. Gershon believes that sleep is critical to the management of symptoms of bipolar during symptom flare ups and even interepisode. Gershon added, “Ongoing monitoring of sleep-affect coupling may provide an important target for intervention in bipolar disorder.”

Gershon, A., Thompson, W. K., Eidelman, P., McGlinchey, E. L., Kaplan, K. A., Harvey, A. G. (2012). Restless pillow, ruffled mind: Sleep and affect coupling in interepisode bipolar disorder. Journal of Abnormal Psychology. Advance online publication. doi: 10.1037/a0028233

Related articles:
Celebrity Revelations of Bipolar Help Reduce Stigma, Increase Understanding
When Depression Can’t Be Cured 
Complementary and Alternative Medicine Therapies for Insomnia, Part II: Mind-Body Therapies

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The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • stressmom


    August 8th, 2012 at 3:39 PM

    Any indication if the bipolar patients were currently being treated for the illness? If so has there been any looking into whether or not the medications could be at the root cause of the sleep disturbances? I know that for me alot of meds tend to be very counter productive when it comes to my sleep. I get all out of whack if I have too many medications or certain families of medicines in me.

  • anne


    August 8th, 2012 at 8:47 PM

    while the importance of sleep is immensely high for even those without bipolar,I can only imagine how very important it is for those with it.Thats is mainly because bipolar individuals are more vulnerable to stress and flare ups and sleep has always been known to be a good medicine against those things.Ignoring our sleep requirements is one of the worst things that we can do to our health and the sooner we understand this the better it is.

  • Tate


    August 9th, 2012 at 4:18 AM

    Every time I read something new relating the importance of sleep to the prevention of so many illnesses, I just think how much healthy we could all be if we would make a conscious decision daily to go sleep a little earlier and increase the quality of our lives. Simple solution, but something that very few of us make a real priority in life.

  • leroy


    August 9th, 2012 at 9:22 AM

    I would have expected to see improved sleep for this group during their interepisode periods.but seems like the symptoms can have an effect even when they are dormant. maybe treatment works better in such a period? maybe it’s the period wherein we can move in and attack the symptoms?

  • GG


    August 9th, 2012 at 1:22 PM

    Remember the doc recommending a lot of rest to overcome a physical illness? its not too different for a mental one either! Sleep is our natural way of recouping and recharging. Any sleep problems should be addressed to on a priority basis, no exceptions.

  • Rachel


    August 10th, 2012 at 11:25 AM

    As a kid I would go hours, sometimes it felt like days, without getting proper rest and sleep. Now if I don’t get my solid 7 or 8 hours then I am a total wreck! No matter how much I guess I can technically “function” without that sleep, it can be a way to quickly drag yourself down if you don’t rest and give your body the time that it needs to refuel and get energy again.

  • alex


    August 11th, 2012 at 4:39 AM

    i am sure that the more sleep disturbance that one experiences, the greater his symptoms must appear to then be
    this would lead me to believe that there should be some resources offered to these patients on how to improve their sleep patterns and how this could lessen the effects that bipolar has over their daily lives

  • Ron Cauble

    Ron Cauble

    August 13th, 2012 at 10:51 AM

    Aren’t there other mental health disorders that also present sleep issues for patients too?

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