Bipolar disorder is a mental health condition where individuals experience extreme mood swings that range from depressive lows to manic or hypomanic highs. Research has shown that sleep disturbances are common in every phase of bipolar disorder—even during periods of remission, patients often report poor sleep quality and irregular sleep–wake patterns. Let’s look at some critical ways in which sleep hygiene plays a role in bipolar disorder treatment.
Disruptions to sleep can lead to significant shifts in mood; for example, reduced sleep has been found to precipitate manic episodes, while excessive sleep (hypersomnia) can exacerbate depressive states.
Given these connections, it is not surprising that clinicians have increasingly turned to sleep hygiene as a non-pharmacological intervention that complements traditional treatments such as mood stabilisers and psychotherapy.
In this context, sleep hygiene is not simply about “getting enough sleep” but about establishing a predictable, calming routine and environment that helps to synchronise the body’s internal clock and regulate mood.
Stabilising Circadian Rhythms
A regular sleep schedule is fundamental to maintaining a stable circadian rhythm—the body’s internal 24‑hour clock that governs physiological processes including hormone release, metabolism, and mood.
Research suggests that disturbances in circadian rhythms can trigger episodes of mania or depression in bipolar disorder. By adhering to consistent bedtimes and wake times, patients can strengthen their circadian synchronisation, which in turn helps to stabilise mood swings.
When patients practise proper sleep hygiene, they provide their bodies with a predictable schedule that supports the natural release of melatonin and other hormones essential for sleep and mood regulation.
Enhancing Mood Regulation
Quality sleep is intricately linked to emotional regulation. Sleep deprivation can impair the brain’s ability to manage stress and emotions, leading to heightened irritability, impulsivity, and an increased vulnerability to depressive or manic episodes.
By ensuring that patients get adequate, high-quality sleep, sleep hygiene practices contribute to more stable emotional responses and better overall mood regulation. Consistent sleep helps to reset neural pathways that are involved in processing emotions, thereby reducing the likelihood of sudden mood swings.
Clinicians often encourage strategies such as turning off electronic devices well before bedtime and creating a dark, quiet sleeping environment to help signal to the brain that it is time to wind down.
Preventing Relapse of Mood Episodes
One of the most compelling reasons for incorporating sleep hygiene into the treatment plan for bipolar disorder is its role in preventing relapse.
Many patients report that disturbances in their sleep patterns precede the onset of mood episodes—whether manic or depressive. By maintaining consistent and healthy sleep habits, patients can reduce the risk of relapse.
Regular, restorative sleep supports the brain’s capacity to manage stress and emotional challenges, and it also improves the overall resilience of the central nervous system.
Improving Cognitive Function and Reducing Stress
Bipolar disorder is often associated with cognitive impairments, including difficulties with attention, memory, and executive functioning. Poor sleep exacerbates these issues by impairing the brain’s restorative processes.
Good sleep hygiene—such as engaging in a relaxing bedtime routine, avoiding stimulants like caffeine or nicotine near bedtime, and keeping a cool and dark sleeping environment—can help improve sleep quality.
Improved sleep, in turn, has been linked to enhanced cognitive performance and reduced stress levels. Stress is a known trigger for mood episodes in bipolar disorder, and by reducing stress through better sleep, patients may experience fewer and less severe episodes.
Augmenting Pharmacotherapy and Psychotherapeutic Interventions
Many patients with bipolar disorder are prescribed mood stabilisers and antipsychotic medications, which themselves can affect sleep architecture. Poor sleep hygiene can diminish the efficacy of these medications, either by interfering with their absorption or by exacerbating side effects such as drowsiness or agitation.
By establishing regular sleep routines, patients can enhance the overall effectiveness of their medications.
Furthermore, sleep hygiene is an integral part of psychotherapeutic approaches such as Cognitive Behavioral Therapy for Insomnia (CBT-I) and IPSRT that also educate patients about the importance of good sleep practices in managing their condition.
Supporting Interpersonal and Social Rhythm Therapy (IPSRT)
Interpersonal and Social Rhythm Therapy (IPSRT) is a specialised form of psychotherapy designed specifically for bipolar disorder. A central tenet of IPSRT is that disruptions in social rhythms—such as irregular sleep–wake cycles—can precipitate mood episodes.
Through IPSRT, patients learn to stabilise their daily routines, including sleep, mealtimes, and other regular activities. Good sleep hygiene practices are a fundamental component of this therapy.
Additional Benefits and Considerations
Beyond these core areas, good sleep hygiene has several ancillary benefits that support the overall treatment of bipolar disorder.
First, it promotes better physical health; chronic sleep deprivation has been linked to metabolic disorders, cardiovascular disease, and immune dysfunction, all of which can indirectly affect mood.
Second, consistent sleep practices help reduce the “social rhythm” disruptions that often occur due to lifestyle factors—such as shift work, travel, or irregular social activities—that can exacerbate bipolar symptoms.
Third, improving sleep hygiene can boost self-efficacy and empower patients, as they gain a sense of control over an aspect of their daily lives that is directly linked to their well-being.
By prioritising sleep hygiene, individuals with bipolar disorder can take an active role in their treatment, harnessing the restorative power of quality sleep to help maintain emotional balance, optimise treatment outcomes, and ultimately, lead more fulfilling lives.
