What is the relationship between bipolar disorder and insomnia?

Dr. Michael Berk, PhD
Psychiatrist (Therapist)

In hypomania (and in mania) the principle difference is that the person who is experiencing hypomania experiences a decreased need for sleep. The person remains energized and not fatigued despite needing considerably less sleep than is usual for them. In insomnia, the person wishes to sleep and would experience fatigue or daytime impairment because of lack of sleep, but struggles to sleep.

Dr. Ruth White, MPH
Social Work Specialist

The irony of the relationship between insomnia and bipolar disorder is that staying up late or going without sleep can cause insomnia (the inability to fall asleep), and lack of sleep can also trigger a bipolar episode, especially a manic or hypomanic episode. People living with bipolar disorder are often sensitive to changes in their internal clocks (circadian rhythms), which regulate sleep. Such changes can be caused by any major change in daily routine or the change of seasons.

Bipolar 101: A Practical Guide to Identifying Triggers, Managing Medications, Coping with Symptoms, and More

More About this Book

Bipolar 101: A Practical Guide to Identifying Triggers, Managing Medications, Coping with Symptoms, and More

After receiving a bipolar diagnosis, you need clear answers. Bipolar 101 is a straightforward guide to understanding bipolar disorder. It includes all the information you need to control your...
Ms. Julie A. Fast
Mental Health Specialist

First some background: Bipolar disorder has two types of mania- full blown mania (Bipolar I) and hypomania (Bipolar II). Within those manias- a person can be euphoric (woo! woo!) or dysphoric (wired, tired and very unhappy). This sleep question refers to the milder euphoric hypomania found in Bipolar II. Everyone with bipolar disorder loves this mood swing, which is why some people don’t want to take medications and lose the mania!

Here is the main difference in terms of sleep between euphoric hypomania and insomnia:

  • People who are in an euphoric hypomanic episode don't want to sleep. (It's such a waste of time!)
  • People with insomnia truly want to sleep and can't. (Oh no, I am going to be so tired at work tomorrow!)

Euphoric hypomania and sleep
People with hypomania don't lie in bed trying to get to sleep. They would rather be cleaning their entire kitchen or working on a great and awesome work project at 2:00 AM. Sleep is such a bother when you're manic!

A friend of mine told me that she polishes her shoes and jewelry in the middle of the night when she’s manic. Funny! I have the thought: "It's only midnight; I can get in the car and go to karaoke right now!" I would never think that when I'm stable. Thanks heavens I've learned not to listen to my manic voice too often. (It still tricks me sometimes.) I miss giving into it.

People with euphoric hypomania are often so awake and it feels so good, the thoughts of how it will affect them the next day aren’t even on their radar.

What is insomnia?
In contrast to euphoric hypomania, people with insomnia are tossing and turning and looking at the clock and feeling miserable and just hoping that they won't be too tired the next day. They get up in frustration and then get back in bed and hope they can sleep. Their brain is racing with how not being able to sleep is going to cause them problems. It's very uncomfortable. They are not depressed or manic; they simply can't sleep that night. Chronic insomnia is a big problem that may be diagnosed as a sleep disorder.

What about you?
If you have bipolar disorder and it's 2:00 AM and you're feeling really good (or your loved one is feeling really good)—and you have written ten questions for, commented on five other blogs, answered most of your email and started to draw a mind map of how you want to redesign your garage. Beware! It isn't insomnia!

Continue Learning about Bipolar Disorder

Treating Bipolar Disorders
Treating Bipolar Disorders
Are you or a loved one living with bipolar disorder? If so, you know that the manic-depressive illness – which can cause major shifts in mood, energy,...
Read More
Can I prevent bipolar disorder?
Mark Moronell, MDMark Moronell, MD
Using illicit drugs to self-medicate the bipolar disorder symptoms can worsen the course of bipolar....
More Answers
Why is bipolar a spectrum disorder?
John Preston, PsyDJohn Preston, PsyD
Many medical disorders have both serious and mild versions. Bipolar Spectrum Disorders include the f...
More Answers
The Symptoms of Bipolar Disorder
The Symptoms of Bipolar Disorder

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.