How do you, a person with bipolar, keep a healthy sleep schedule?

April 5, 2022 7:22 AM

Bonus points for sleep health recommendations which do not require prescription medication.
posted by lazaruslong to Health & Fitness (7 answers total)

I do not have bipolar but a close family member does. This is what works for them (some of this works for everyone, some of it is bipolar specific)

- Make sure your schedule gives you enough sleep. If you need 8 hours a night that's not a weakness, that just means you're a normal human being. People who genuinely need less than 7 hours sleep are unusual (not bad, not freaks, just statistically unusual), so don't feel that sleeping for 8 full hours is somehow a problem.

- Go to bed and get up at the same time every day (i.e. have a sleep schedule and stick to it). If you struggle with this, try doing it at the weekends as well. Sounds awful, but if you're getting enough sleep (see above) it's actually very easy.

- Keep the bedroom cool because it's easier to get to sleep and easier to stay asleep when it's cool.

- Likewise don't go to bed hot for the same reason. Have a cool shower before bed if necessary.

- Stay hydrated through the day. This is especially important if you are on lithium anyway, but water helps you stay cool regardless and you'll eat a little less, so fewer digestive processes to keep you awake.

- Change the bed regularly (once a fortnight or so) and if you have a bad night's sleep change it the next day so it feels fresh that night (and also, if you do nothing else that day at least you've changed the bed).

- Make your bedroom as inviting for sleep as possible. That might mean muted colours, or keeping it clean, or lots of calming nightlights, or putting those luminous stars on the ceiling, or something else completely, but make it a place where you feel calm and restful.

- Depending on your preference a white noise generator or an 8 hour YouTube track of chill piano jazz playing very quietly can stop the blackness feeling all-encompassing or overwhelming.

- If you have a cat or a dog, consider letting them sleep on the bed with you if they don't already. There is something wonderfully soothing about having a furry companion snoozing away at the foot of the bed, and they'll love it too. You're never alone with a cat or a dog.

- Know that sometimes mania will stop you sleeping. Accept that. Your mania will pass. It's hard during mania to "know" that things will be ok, so write it on a post it note on the bedside table if you need to, and make it part of your normal thinking about sleep so that when mania hits it's easier to remember.

- Know that sometimes depression will stop you sleeping. Accept that. Your depression will pass. It's hard during depression to "know" that things will be ok, so write it on a post it note on the bedside table if you need to, and make it part of your normal thinking about sleep so that when depression hits it's easier to remember.

- Those last two point are not the same in practical terms because mania and depression are very different. But they are both parts of your illness which are not you, and knowing that fact when you are in them is something to cling on to until the calm returns or the black veil lifts, or at least until the morning comes.

- Depending on your living arrangements, don't lie in bed with insomnia. Get up and read a book, do a puzzle, clean out your sock drawer, get some exercise, do whatever, but do something. If you can't sleep you can be apprehensive about going to bed the next night, which means you don't sleep, which means you feel apprehensive, and BANG you've got mania. But if you do something with your insomnia you're more likely to sleep the next night (or you might not, but the feeling of having done something is better than the feeling of lying awake in bed while the whole world sleeps but you).

- When all else fails, nap or sleep during the day if you have to. Getting the sleep is more important than when you get the sleep because exhaustion/lack of sleep is (for my family member and a lot of the fellow sufferers they speak to) one of the guaranteed ways of making them unstable and slip into mania or depression. YMMV, but if that's you then prioritise your sleep over everything, because you can cope when you're stable.

Good luck, I hope some of that helps. Keep anything useful, throw the rest away.
posted by underclocked at 9:02 AM on April 5, 2022 [6 favorites]

I have bipolar, and have to say that underclocked has nailed it. I would only add that I stay away from caffeine after 3pm. It really makes a difference for me. Caffeine tends to assist my mania and keep me from being able to sleep. I also would say its important to recognize that your sleep schedule will be disrupted from time to time, and to plan for it. When it does, it may take you several days to catch up. That's almost harder for me than mania. Functioning without sleep during mania seems to be something I can do. Functioning while trying to get myself back into a sleep schedule is harder. During those times, I schedule myself a little more sleep time, say 1-2 hours nightly for 3-4 nights. It sounds counter-intuitive to the advice that underclocked gave but it does seem to work for me.

I keep several clean pillow cases nearby because for me a clean pillow case is super important. Find what is important to you, and stick with it.

I wish you only the best.

Feel free to me-mail me if you have other questions that you might need help with.
posted by I_count_crows at 10:51 AM on April 5, 2022 [1 favorite]

I don't have bipolar but several family members do, and I do have gnarly circadian rhythm issues.

I'll add:

1- Sensory deprivation. Blackout curtains, sleep mask, earplugs.

2- Regulate your cortisol and melatonin. Do everything you can to reduce stress levels. Take in as much sunshine as you can, especially first thing in the morning, again in the afternoon and at dusk. I take 150-300 mcg of melatonin 4-5 hours before sleep and also 1 hour before bed. (You'll need to special order 300 mcg pills online, the doses you see on shelves are way too high.) I also drink a cup of valerian tea and listen to soothing instrumental music. Create a nice ritual!

3- Control your lighting. Use warm red tones at night and dim lamps over the course of several hours. Cover all blinking electronic lights, even microwave panels and outlet strips. I use black electrical tape.

4- Social rhythm therapy.
posted by lloquat at 12:23 PM on April 5, 2022 [2 favorites]

Really the key for me is having a set bedtime so that I get the sleep I need (~8 hours) and setting alarms. I can get away with a lot if I keep to that, and if I DON'T keep to that, everything falls apart.
posted by fiercecupcake at 3:26 PM on April 5, 2022 [1 favorite]

Exercise, allegedly. Not that I would know from experience. I also listen to lots of mildly interesting podcasts since it keeps the thinking at bay - the thinking is often adding to the disruption.
posted by lookoutbelow at 12:29 AM on April 6, 2022 [1 favorite]

I do two sleeps. Long nap right after work (ideally at 3-4pm). I wake back up around 9-10pm, do stuff, then as soon as I am even vaguely sleepy I go back to bed no later than 1-2am. I start my day at 7am. That 9pm to 2am time slot is when I get a lot of cleaning and chores done. My doctors think it's weird but they support it because I genuinely am healthier and happier doing it vs when I force a "normal" sleep cycle.
posted by The Adventure Begins at 2:01 PM on April 6, 2022 [1 favorite]

I am bipolar and don't take medication. I have found that intense, outdoor exercise makes me exhausted enough to sleep well. I prefer to spend at least a couple hours a day outside skiing, walking, or biking. I gather that many people have too many other commitments to do this, and I feel lucky to be able to.

I have had mixed success with marijuana in the evenings. Diphenhydramine (a.k.a benadryl, marketed under different names as both antihistamine and sleep aid) is more reliable, but also gives me more of a hangover the next day.

I struggle with sleep more when manic than when depressed.

I allow myself one night of way too little sleep. When that happens, I exercise more and/or take diphenhydramine the next night.
posted by gorillawarfare at 4:17 AM on April 12, 2022 [1 favorite]