What does the word “mania” sound like to you? Does it sound like a high that some people spend large sums of money, energy, and sanity to attain? Does it sound like an adrenaline rush? The peak of a roller coaster, or a sort of euphoria perhaps? While our mind’s eye pictures “highs” in this sort of way, a bipolar manic high can be completely devastating to the person experiencing it. Its effects may include “elevated mood, inflated self-esteem, decreased need for sleep, racing thoughts, difficulty maintaining attention, increase in goal-directed activity, and excessive involvement in pleasurable activities.” While a manic episode may sound a little like an amped up version of your morning caffeine rush, its effects may greatly impact not only the individual diagnosed with bipolar but also have lasting effects on the family members and friends who may be affected by actions taken during this time when one exhibits little control over their actions and their related consequences. While manic episodes are an unfortunate reality for most bipolar patients, new research suggests that these extended euphoric episodes could actually be naturally triggered by extended periods of sleeplessness.
It is commonly known today that sleep deprivation affects many aspects of our physical health and our cognition. Insufficient sleep can make it difficult to concentrate, remember, and retain information and even to regulate your emotions. It also contributes to obesity and cardiovascular problems and has also been linked to a much faster rate of developing dementia as one ages. One University of California professor, Matthew Walker, who has spent the last 20+ years of his life researching sleep and its effects on people and their cognition, even goes as far as to suggest that sleep should be thought of like work or any other mandatory responsibility because of its importance to how we function and our longevity. “[Sleep] needs to be prioritized, even incentivized,” he says, in order to break the cycle of what he calls the “catastrophic sleep-loss epidemic.”
While Walker points to startling physical and mental effects that sleep loss has on our bodies over time, preventative care is not the only reason to get your eight hours of shut-eye per night. Those with pre-existing mental health disorders are also greatly affected by lack of sleep. Bipolar, for instance, had previously been connected with sleep disturbances such as insomnia, but these sleep disturbances were most often thought of as an effect of the manic episodes and not necessarily the trigger. It turns out that lack of sleep can actually precede the patient’s decline into mania. The previously-mentioned study, just recently published by Cardiff University researchers led by Ph.D. student Katie Lewis, shows a clear connection between sleep loss and manic episodes in bipolar disorder. According to her findings, “20% of people with bipolar disorder reported that sleep loss had triggered episodes of high mood, whereas 12% reported that sleep loss had triggered episodes of low mood.” Though she did find that women and those with bipolar I were more likely to experience this sleeplessness-mania correlation, Katie and her researchers still discovered the same general patterns across her study population even when accounting for age differences, intensity of illness, and other similar variables.
This is a significant finding because a link like this between sleep and manic episodes can prompt new research studies and possible avenues for new treatment options. While this link between bipolar and sleep is relatively unexplored as of yet, research has already been done on the effects of sleeplessness as it relates to depression. Extended periods of wakefulness has actually been shown to be effective in kickstarting treatment for depression, believed by researchers to be due to the fact that lack of sleep prompts your body into a deeper sleep cycle the next time it has a chance to rest. The fact that a deeper sleep cycle can help with mood regulation is an unsurprising result when compared to the Cardiff University study on bipolar. However, much more research still needs to be done on the topic in order to understand its correlation to mental health even more clearly. Perhaps in the future, as Matthew Walker states, the importance of sleep will fully be recognized, and people will begin to think of sleep as a prescription for mental health, and not an unnecessary burden cutting into their social time and leisure activities.
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Lewis, K. S. et al. Sleep loss as a trigger of mood episodes in bipolar disorder: individual differences based on diagnostic subtype and gender, The British Journal of Psychiatry (2017). DOI: 10.1192/bjp.bp.117.202259
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