Bipolar disorder is a condition that causes extreme swings in mood that affect thoughts, behaviors, and energy levels. It can also affect a person’s sleep, including causing unusually vivid dreams, nightmares, and night terrors.1
This can be a frustrating experience for people who are already dealing with the ups and downs of their condition. Unfortunately, some medications used to treat bipolar disorder are also linked to sleep disturbances and nightmares.
At a Glance
Many people with bipolar disorder experience nightmares and even night terrors. This can become even more troubling when coupled with either insomnia or too much sleep, depending on whether they’re experiencing a manic or depressive episode. Keep reading to learn more about the sleep disturbances you might face if you have this condition and some of the steps you can take to get better, more restful sleep.
Dreams and Nightmares in Bipolar Disorder
Nightmares are disturbing, well-remembered dreams that usually incite anxiety and fear. They typically occur later in the evening during rapid eye movement (REM) sleep and cause a person to wake up abruptly.
Some researchers believe that nightmares in people with bipolar disorder may predict upcoming mood shifts.2
The exact causes of this are not clear. However, researchers do know that nightmares tend to be more common in people with mood-related conditions. People with major depressive disorder (MDD), bipolar disorder, and schizophrenia have nightmares more frequently than the general population.3
Nightmares in Children
Children who have bipolar disorder may suffer disproportionately from nightmares. Dreams of explicit violence, gore, and death as well as dreams that signal a fear of abandonment have been reported.
Of course, most children experience nightmares on occasion. Children with bipolar disorder, however, can experience these more significantly.4
Night Terrors in Bipolar Disorder
Night terrors are also common in people with bipolar disorder.5 Unlike nightmares, night terrors do not occur during REM sleep.
What Is a Night Terror?
A night terror isn’t a dream, but rather an abrupt awakening accompanied by physical symptoms like feelings of intense fear, screaming or thrashing, and elevated heart rate and blood pressure, among others.
During a night terror, the person awakes in a state of terror and is typically confused and inconsolable. They may or may not recall the episode in the morning.
Night terrors are rare in adults, yet many who experience them have other mental health conditions, such as bipolar disorder, depression, and anxiety.5
In these episodes, people may abruptly sit up in bed, sometimes screaming or thrashing around in fear. They seem confused and don’t recognize anyone; some even run from the bedroom in an apparent attempt to avoid harm.
Lamictal and Dream Abnormalities
Lamictal (lamotrigine) is a mood stabilizer approved by the Food and Drug Administration (FDA) to treat bipolar disorder and certain seizure disorders. It effectively prevents the recurrence/relapse of mood episodes in both bipolar I and bipolar II.6
However, some people who take Lamictal can experience a variety of sleep-related side effects, including an increase in nightmares and abnormal dreams. According to the manufacturer label, approximately 6% of people with bipolar disorder experience some type of dream abnormality while taking Lamictal.7
If you think Lamictal is causing abnormal dreams, talk to your doctor. Remember that it’s never a good idea to stop taking a medication cold turkey or change the dose of a medication without first consulting your healthcare provider.
Coping With Nightmares in Bipolar Disorder
Researchers don’t fully know what causes people with bipolar disorder to experience nightmares and night terrors. What is known is that the continuation of these sleep disturbances increases the severity and frequency of symptoms during both manic and depressive episodes.
Getting a good night’s sleep is essential to living a manageable life with bipolar disorder. If you’re struggling with sleep disturbances such as nightmares or night terrors, experts recommend you do the following:
Bedtime
Establishing a bedtime routine can improve sleep timing and consistency, which is important for sleep quality.8 Stick to a set of habits that help prepare you for rest each night. Take a bath, read a book, or listen to some music to calm your body and help set the mood for a sound night’s sleep.
Creating a routine can give your mind something to focus on instead of your worries and anxiety.
Avoid Sleep-Interfering Substances
Avoid substances that interfere with sleep. Some substances like caffeine prevent you from sleeping. Others, such as alcohol or marijuana, can help you fall asleep but can affect the quality of your sleep. Avoid all for a more restful sleep.
Exercise
Research suggests that regular exercise can be important in improving sleep quality.9 It also helps maintain good health.
However, exercising too late in the evening can significantly interfere with your ability to fall and stay asleep, especially if you have bipolar disorder. Exercising in the earlier part of the day, on the other hand, can help support healthy sleep.
Get Medical Help
Talk to your doctor. If you’re concerned about the frequency of your nightmares or night terrors, schedule an appointment to see your doctor. You might also want to ask your doctor whether any of the medications you’re taking (both over-the-counter and prescription) cause sleep problems as a side effect, and whether an alternative option may be more suitable.