Bipolar Disorder and Sleep Quality

I have known many other people who live with the diagnoses of bipolar disorder, depression and/or anxiety and one of the biggest complaints I have heard from these individuals is regarding poor sleep quality.

One very big reason I have encountered so many people who suffer from insomnia as a comorbidity of bipolar disorder is because I was a sleep tech for eight years. If you aren’t familiar with what a sleep tech is, it’s a medical provider with the primary goal of diagnosing and treating sleep apnea.

While many who are referred to the sleep clinic by their physician do have sleep apnea, many of those with bipolar disorder, depression, anxiety and other mental illnesses actually often suffer from idiopathic insomnia, meaning the inability to fall asleep or maintain sleep is a byproduct of another condition - in this case, psychiatric disorders.  Chronic insomnia impairs one’s ability to function properly at work, while driving, at home with family, and the reason is when you are unable to meet your brain’s need for sleep, it affects neurochemicals, such as dopamine and serotonin, thus altering your brain’s biology.  As the poor sleep quality compounds night after night, one’s mood can be altered, most commonly causing depression.  The majority of the patients on whom I conducted sleep studies, and who did demonstrate significant episodes of sleep apnea were also frequently suffering from depression, for the very same reason. 

With sleep apnea, what generally occurs is, when there is an obstruction in the airway during sleep - most commonly, the absence of muscle tone while breathing during sleep will cause your airway to collapse causing the hindrance of breath, or even the complete cessation of breath for ten or more seconds.  The hindrance of breath is known as a hypopnea, while the complete cessation of breath is referred to as apnea. I have witnessed patients who completely stop breathing for as long as two minutes before their legs or body jerk enough to wake them slightly in order to catch their breath again.  Your brain loses oxygen during an apneic event and in order to resolve the issue, your brain sends out a signal to cause a jerk, most frequently shown in the leg muscles during a sleep study.  The repetitive jerking and associated arousals, even when they are only two seconds in length, can significantly disturb your sleep causing excessive daytime sleepiness, depression and puts you at risk for high blood pressure, weight gain, type two diabetes, and many other additional health concerns. 

These critical health risks can affect anyone who suffers from poor sleep quality.  Having experienced extremely poor sleep quality throughout my adult life, and also having been an educated sleep tech, even when practicing good sleep, my sleep quality ranged from MAYBE getting a few hours of sleep per day or night to having a crash period, usually lasting a full weekend, and most frequently I would stay in bed during my rotated weekends off.  At least once a month, I would also have a day or night (depending on my work schedule), when I did not sleep at all for 36-42 hours, even after working a ten-hour shift the night before and another ten-hour shift the night after getting zero sleep.  I walked the earth like a zombie, a nauseated zombie.

After about two decades of living like this, suffering from depression most of that time, and having tried every sleep aid I knew existed, finally I found a psychiatrist who suggested Seroquel for my mood stabilizer to treat both the Bipolar Disorder AND the insomnia.  And now, I can function most of the time.  Nothing else, no other sleep aids, has ever been an effective solution to my insomnia for over two decades.  As a result of my insomnia, during depressive episodes, which did dominate my mood probably at least 70% of the time, I would either completely lose interest in food completely or it’s all I could think about.  My weight would fluctuate from less than 100 pounds to as high as 175 pounds, more recently the latter.

While I can’t guarantee Seroquel or any other particular medication is a good fit for you, since everyone is different, it may be a possibility worth discussing with your psychiatrist and potentially exploring further, even as a piggyback to your current treatment, and may just be what you need to help you crawl your way out of those depressive experiences.  I do believe that I lack sensitivity to medications, much more than the vast majority of the human population.  Somehow, most medications I have taken are just not as helpful for me as they are for most people, or at least that is the impression I get.  I find myself feeling envious that wimpy prescription drugs work well for so many people but for me, it’s about as helpful as popping a Tic-Tac.

Be sure to talk to your doctor if you are experiencing chronic insomnia along with depression.  He or she can help you decide on the best and most effective course of treatment for you.