Most bipolar experts, including people with bipolar disorder, agree on the importance of maintaining a good sleep-wake cycle. Diminished sleep is often the first sign of an approaching mood episode, typically manic, mixed, or hypomanic. For others, an increased amount of time in bed can be a symptom of an approaching depression.
Strategies to improve sleep include:
• An increase in strenuous morning exercise
• Elimination of all non-sleep behaviors from the bed; i.e., don’t read, eat, or watch TV in bed, just sleep there
• Avoidance of alcohol, because while alcohol may put you to sleep, or pass out, the quality of sleep is poor, and the overall amount of sleep is diminished
• Avoidance of caffeine, especially after noon; if you think you’re shifting to a mania, cut it out all together. If you’re on lithium, be aware that this may increase your lithium level.
• Arrangement with your provider to have a sleeping medication when needed
• Establishment of a regular bedtime and wake time
• Making sure your bedroom and bed are comfortable, free from noise, at the right temperature, etc. Some people who are highly sensitive to noise and light find ear plugs and sleep masks to be helpful.
• If you’re lying in bed and are unable to sleep for more than half an hour, get out of bed, do something relaxing, watch TV, listen to music, have a glass of warm milk, and only return to bed when you think you’ll be able to fall asleep.