How to Sleep During a Manic (Bipolar) Episode

Three Methods:Calming Your MindBuilding Better Sleep HabitsGetting Outside Help

Disruptions in sleep are common in bipolar disorder. These disruptions can create a downward spiral into hypomania (near constant irritability) and even full-blown mania. If you are currently in a hypomanic or manic episode, falling asleep can be challenging. Adopting better sleep habits and getting outside help are some of the best solutions for getting to sleep with bipolar disorder.

Method 1
Calming Your Mind

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    Lie down and do a deep breathing exercise.[1] Place one hand on the chest and one hand on the stomach to monitor your breaths. Take a slow, deep breath in through your nose filling up your lungs. The breath should be coming from your stomach; you should not feel your chest moving. Then, slowly release the air from your mouth, feeling your stomach deflate as the air leaves. Practice doing 4 to 6 breaths per minute, repeating the cycle for 10 or more times.
    • Get ready for bed as you normally would but perform this exercise to help calm your mind and make getting to sleep easier. You may also perform this exercise while sitting in a chair.
    • Deep breathing can be helpful for calming the rapid thoughts and anxiety that may accompany mania during any time of the day or night. No one has to know you're even doing the exercise.
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    Learn to practice meditation. This technique can be a terrific way to cleanse your mind of negative thoughts and promote relaxation. Sit in a quiet room with your legs crossed on the floor or with your back straight in a chair. Close your eyes. Breathe normally, focusing your attention on each inhale and exhale. Refuse to let your mind wander, returning your attention to the breath each time you go astray. Do this for a few minutes until you build up to longer periods.[2]
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    Do progressive muscle relaxation when you cannot relax. This relaxation method can be done on your own or with a guided video. Sit comfortably in a chair. Take a few deep breaths, breathing in calm and breathing out tension. Slowly, moving up through your body, tense one muscle groups and hold for a few seconds. Release the tension and notice how it feels. Move up to the next muscle group until you have done your entire body.[3]
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    Turn on a guided imagery video to help ease into sleep. This form of relaxation involves a number of techniques that use the senses to reduce anxiety and stress. A guided imagery session may require you to imagine that you are on a serene walk through a meadow or wading through the ocean. YouTube has numerous guided imagery videos you can watch free.
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    Get regular physical activity. Exercise can be a great way to calm anxiety or your mood during a manic phase of bipolar disorder.[4] However, so that the activity does not further cause disruption in your sleep, try working out in the morning or at least several hours before bed.
    • Your exercise regimen can include moderate activities like yoga, Pilates, or a walk through the park. You can also engage in more vigorous forms of exercise such as running or high intensity interval training.
    • No matter what type of exercise you choose, the benefits outweigh those of not doing any at all. Regular exercise can improve mood, lower risk of disease, and may even help with the depressive episodes you experience with bipolar.[5]

Method 2
Building Better Sleep Habits

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    Establish a nightly routine. You may be able to prevent manic episodes from happening in the first place by practicing good sleep hygiene. This can be very effective at curing sleeplessness in individuals with bipolar disorder - even those in a manic episode. Consider developing a winding-down routine to get you in the right mind-frame for sleep.[6]
    • A nightly routine may consist of doing light stretching, tidying up your home, preparing your clothing for the following day, taking a hot bath, and reading a book. Try to do things that do not involve bright lights or technology since these things do not signal to your brain that it is sleep time. Do calming activities that indicate to both your brain and your body that sleep time is nearing.
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    Limit bedroom activities. The bedroom should be associated primarily with sleeping. If you are a person that does work on your laptop in bed or watches TV while in bed, you may need to change those habits to get to sleep. Try moving distracting activities from the bedroom and do these in another area.
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    Create an optimal sleeping environment.[7] If your bedroom is comfortable and inviting it will be easier to fall asleep there. Get a cozy mattress, bedding, and pillows to create an environment conducive to sleeping. In addition, cover your windows with black-out curtains to let minimal light in. Turn down your thermostat to a cool temperature.
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    Minimize alcohol and caffeine intake before bed. Depending on any medications you are taking, you may have already been instructed to limit these beverages completely. However, if you have been cleared to drink alcohol and caffeine, keep consumption to several hours before bed.[8]
    • You may be surprised at the advice about not drinking alcohol before bed. Most people will feel drowsy after one or two drinks. Even though alcohol may help you fall asleep, it does not promote good quality sleep and you may wake up hours later and be unable to fall asleep again.
    • Caffeine is a stimulant, so the last thing you want to do in the hours before bed is stimulate yourself even more than you already may be with manic symptoms. Cut caffeine intake in the afternoon to sleep better at night.[9]

Method 3
Getting Outside Help

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    Find a psychiatrist with experience in treating bipolar disorder. Your doctor will help you determine a medication regimen that will help you control bipolar symptoms. Always take your medications as prescribed, since skipping a dose may induce a manic episode. Alert your doctor if you are having sleep problems. Consistent sleep deprivation may exacerbate bipolar symptoms, affect quality of life, and even lead to a substance abuse problem.[10]
    • Some medications such as antidepressants may actually cause sleep disruption.[11] If you are taking such medications, talk to your doctor to see if you can change your meds or add additional meds to your current regimen that will help you sleep better.
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    Consider trying interpersonal and social rhythms therapy (IPSRT). This is a form of psychotherapy based upon the idea that bipolar disorder is caused or made worse by disruptions to circadian rhythms and sleep deprivation. Its goal is to reduce the reoccurrence of manic episodes.[12] IPSRT can be conducted one-on-one or in a group setting. It focuses on helping people with mood disorders like yourself better manage their everyday lives with routines and strategies to improve sleep and manage stress.[13]
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    Ask your doctor if you can take melatonin. Melatonin is a hormone that is naturally secreted by the body. It helps regulate circadian rhythms and acts as an internal clock controlling sleep. Secretion is high at night and low in the morning and during the day. Talk to your doctor to see if this supplement may be useful in helping you achieve better quality sleep.[14]
    • Your psychiatrist may also suggest non-addictive sleep aids that can be purchased over-the-counter like diphenhydramine.[15]


  • Maintaining healthy sleep habits should help you to better control sleeplessness and excitability that may occur with mania. Try to avoid sleeping too much or too little which can both drastically affect your mood with bipolar disorder.
  • Always talk to your primary psychiatrist before taking any over-the-counter medications or before commencing any new regimens. Small changes in your life may upset your mood, so get the OK from your doctor beforehand.

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Categories: Bipolar Disorder | Better Sleeping