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Sleep disturbances is an intrinsic component of bipolar disorder. It can take the form of periodic or lifetime problems getting to sleep, staying asleep, or waking up. During inactivated periods of the illness, sleep problems are usually manifested as difficulty getting up in the morning and a desire to sleep during the day, called hypersomnia. In bipolar depression, where hypersomnia combines with symptoms of fatigue and low motivation, many patients end up feeling that the only thing wrong is that they need a good night's sleep. Ultimately, the solutions is to treat the underlying bipolar disorder that is causing the sleep problems and then the symptoms will get better.

In mania, the inability to get to sleep is often exacerbated by purposefully staying up all night, watching television, surfing the Internet, or engaging in other stimulating activities. I remember interviewing a young bipolar woman who had come to see me for insomnia. I asked her, "What is it exactly that keeps you from falling asleep?" "It is usually the headphones or a video game," she said dryly. "I make myself stay up all night."

Can insomnia trigger a bipolar episode?
One of the surest ways to trigger mania symptoms is to stay up for twenty-four hours or more. Conversely, my experience has shown that adequate, regular sleep reduces the symptoms of bipolar disorder.

My problem is that I sleep too long in the morning. I need a pill to wake me up.
When I hear this, I usually find that the problem comes from going to bed too late. If you go to bed in the early morning hours, there is nothing that can help you get up in the morning because you simply aren't getting enough sleep. Go to sleep early and after a few days, you will find it easier to get up on time. If you cannot stay asleep then lie in bed quietly with your eyes closed.

However, if you find you are sleeping ten or more hours a day, you may be suffering from bipolar depression. Sometimes, you may have to wait for the depression to ebb before excess sleepiness goes away. Discuss this with your doctor and see if your bipolar disorder can be treated more effectively to minimize this problem.

I don't have to sleep anymore, and I still have energy! I'm ecstatic! It feels like a gift from God.
Mania prompts many individuals with bipolar disorder to feel that they do not need any sleep or only a few hours of sleep a night. Nevertheless, nobody can stay healthy if they do not get an adequate night's sleep. Insufficient rest produces an excess strain on the body, interferes with performance, impairs memory, lowers the seizure threshold, and probably shortens life span. The solution is to strengthen your bipolar treatment so that the mania subsides, and your sleep will become more normal.

Six months ago, I couldn't wake up. Now I can't get to sleep. What's the deal?
This may be a sign that you are starting a manic cycle. First, check whether there are any manic triggers such as stress, drugs, or alcohol use that you can reduce by yourself. Then ask your doctor if you should have stronger bipolar medications to block a manic episode.