Archive for the ‘sleep’ Category

Mania and Sleep Reader Comments

Monday, July 27th, 2009

Thanks to everyone for such amazing and insightful comments on the Mania and Sleep blog post. The topic is obviously so important. It really is such a chicken and the egg problem. I can be in bed and unable to sleep and I have to go through my list- am I just wound up because I stayed out late? Will I get to sleep eventually? Is it possible it’s agitated depression? What if it’s hypomania?

Then I have to truly assess if I will actually get to sleep if i just lie there. I listen to my Ipod podcasts – which helps a lot. I do sleep exercises (counting something!) and breathing. I do it all! And if I’m still awake, I say to myself.  “Ok Julie, it’s essential that you sleep at least seven hours. Take your sleep meds!”

Why is it such a struggle? I think we all want to just sleep normally and bipolar can make this super hard- so the chicken and the egg- does the sleep trouble come from a trigger than can then lead to bipolar symptoms- or does the bipolar make it hard to sleep!

 If you look at the blog post below, you will see a small button at the top of the post where you can click to read the comments. Wow, I learn so much from everyone.

 Julie

A mania tip: If you are slightly manic and go to a crowded beach all day- it can increase the mania because of the sunlight. Wear super dark glasses and sit under an umbrella. Isn’t it amazing that the sun can affect us so strongly!

Bipolar Disorder and Sleep: Mania vs. Insomnia

Thursday, July 23rd, 2009

Manic sleeping problems are different from insomnia in many ways- with insomnia you’re tired, you want to sleep, you toss and turn, you worry about how tired you will be in the morning, you want medication relief.

With mania! Whew! you want to stay up, you’re wide awake and doing something, you have unlimited energy, a racing mind, lots of creative thoughts (whether they are truly creative or not, they feel creative.) You have no desire to get in bed and sleeping feels like a real waste of time. It takes more meds to knock you out and there is a chance you will be even more manic the next day.

Here are some of the things you may think when you’re manic at night:

Sleep is SUCH a waste of time.
It’s only 1:00 AM. I could go to the grocery store right now!
The tile really needs to come up in the bathroom.

These manic thoughts can be funny- but many people act on them! When you have insomnia, you just lie in bed and punch your pillow and wish you could just get some sleep so you won’t be tired the next day!

If you’re having trouble sleeping and it’s accompanied by active thoughts that have a lot of energy around them- such as actually cleaning your whole house at 3AM. It’s time to talk with your health care professional. Now.

Julie

Bipolar Disorder and Sleep: I want to fall asleep on my own tonight

Tuesday, February 3rd, 2009

It’s a great night when I can get to sleep without sleep meds. I go through long periods when I’m fine and then I have nights where I simply won’t sleep unless I take my Ativan. It’s not that I don’t want to sleep- and it’s not that I’m manic. I just won’t sleep. I just lie there. Then I start the brain tug of war:

Brain #1  Julie, you really should be able to just go to sleep on your own. Other people don’t need meds to sleep. You will be too tired in the morning if you take the Ativan.  Just keep trying to get to sleep on your own! Just put on some calm music. Smell some lavender!

Brain #2  Julie, this is not a joke. You have bipolar disorder and that means you have sleep problems. TAKE YOUR MEDS! It’s not like you’re drinking wine or smoking pot to sleep. These are MEDICATIONS!  You have never taken more medications than needed in your life. Why do you always have to make this so difficult? It’s 2AM. Stop trying to talk yourself out of it and take your meds!

I can tell tonight is one of these nights. I will probably get in bed and listen to something calming and then still be wide awake. But I know myself. I have to at least give myself a chance to fall asleep on my own.  I did all I am supposed to do for a good night’s sleep. I got home early from karaoke. I didn’t overeat. I wasn’t in cigarette smoke- no smoking in Oregon finally! and I am not watching TV or a DVD right before bed. But it doesn’t look good.. oh well! I have the Ativan ready!

Julie

Bipolar Disorder and Sleep: Football, friends, brain chatter and Ativan

Sunday, January 4th, 2009

Sorry guys, I am going to be a broken record for a few days about my travels and how they affect bipolar disorder. I’m on the East Coast and wow, I have had sleep problems. Last night I stayed up late (midnight) to watch the football playoffs and when I finally got to bed I had visions of Payton Manning (quarterback of the Indianapolis Colts) throwing the ball all night. Then I heard words from the game and words from the conversations with my friends. I really love being with people, but I easily get overstimulated. It’s not good for me.

This brain chatter is like having a train go through my head. It just won’t turn off. I have a section in my book Get it Done When You’re Depressed called Expect Brain Chatter.  I just read that strategy again. It’s true- the running commentary in your head that keeps going even when you’re sleeping can be very stressful and tiring!

Eventually, at 2:30 I just took some of my Ativan (Lorazepam) in order to sleep. I am lucky it works well for me at a very small dose. I can get to sleep on 1mg or even .5 if I’m already a bit tired.  I don’t know why I just don’t take it from the beginning. It’s like I feel I have to get to sleep on my own in order to prove something. This has always been a struggle. I just need to take the darn stuff.

I am worried about these sleep problems, but I want to have fun tonight with my friends! We are going to watch football and talk. So what can I do to make sure I sleep well! I will work on that. It’s always a trade off, isn’t it.

Julie

I slept nine hours!

Thursday, September 25th, 2008

Well, nine hours of sleep is so amazing for me I actually woke up and wanted to do a little jig. I’m what I call an undersleeper. I was actually talking with my friend Kristin yesterday- she’s the author of Bipolar and Pregnant, and we spent a long time talking about bipolar disorder and sleep. Here are all the ways it affected our sleep:

#1. Issues due to meds. Kristin talked about Topamax. She has no idea if it affects sleep- but she’s pretty sure it affects memory. Kristin uses Lunesta to sleep.

#2. When I’m depressed, I have agitated sleep which means my brain doesn’t shut down at night. Bother! I use Ativan to sleep when it gets bad.

#3. Of course, mania is the biggest problem. I rapid cycle almost daily, so on the nights I can actually fall asleep normally and get 7-8 hours of rest is pretty great!

#4 . Excessive tiredness from medications- especially some anti depressants. Whew, I used to get so tired my lips got numb and I slept 14 hours a day. No kidding!

 Many people in this industry say that regulating sleep is the #1 way to manage the illness. How is your sleep? I need to write a book on the topic!

 The buzz word these days is ’sleep hygeine” I am not even sure how to spell the word! Ah, here it is: hygiene!

Julie

Reader Question: Travel and Bipolar Disorder

Friday, August 29th, 2008

Here is a question about travel from Karen:

Julie, was your plan to adjust your sleep schedule a week ahead of time successful?  My BP husband must travel from the West coast to East next month and I have been frantically searching for ways to help him do this without becoming ill.  Thank you in advance for your answer!

Karen

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Karen wrote this question in a comment about my blog post on how I deal with time changes now that I can travel again- if you go to the menu on the right, you can click on travel and the post will come up called Traveling to the NAMI Convention in Florida. It helps to read that before you read this post.

Hi Karen,

I always tell people with bipolar disorder to think way, way ahead about time changes when they travel.

Have you ever noticed that when we hear a tragic story about bipolar disorder in the news-  the cause of the mood swing was often travel where a person’s sleep and medications got off schedule?  I listen to these stories whether it be of a football player who misses the Super Bowl- or someone who became ill after traveling to a wildly different time zone such as going to South America and I think- we HAVE to have a plan for everything we do. Bipolar disorder does NOT like change, especially time changes.

Bipolar disorder runs on a very strict biological clock- which is why shift work is considered one of the top triggers of bipolar disorder- in fact, my coauthor Dr. John Preston lists this second after drugs and alcohol as a main trigger!

The answer to your question is YES- planning ahead for my travels to the East Coast has been very successful- but it takes a strict plan.

I’m speaking at the DBSA conference in Virginia in two weeks. This is a three hour time change- which may not seem like much- but it is to us with bipolar biological clocks. Here is what I’m going to do and what your husband can do as well. :

1. Start to get on East coast time one week before the trip- this simply means going to bed one hour earlier for a few nights- you then go to bed two hours earlier for a few nights and then three hours earlier the two nights before. This is actually very easy from this direction as it just means you get up really early.  For many people, simply not watching TV at all the week before the trip really helps. No late night news, sports games, etc. No karaoke with friends for me!

2.  I have to repeat this one, no late night television or computer use for a week before the trip. These activities are really stimulating!

3. Change your eating patterns to fit East coast time.

4. If possible, book a flight that fits the East coast time zone. In other words, leave early in the morning!

5. Have your bag packed WAY ahead of time! This avoids the late night rush that many people have before a trip.

6. I then do the reverse for the way back. I go to bed later and later to prepare for the return home. We often don’t work on our last travel day- so we can sleep in a lot more.  When I was in Florida- I stayed up until 2AM and slept until 9AM. I have to use sleep meds to do this. 

It really does make a huge difference- I use the hotel call service for my alarm.

7. I don’t drink at night or go to karaoke, night clubs or late dinners when I’m on a work trip. It’s too stimulating.  Luckily the hotels have movies!

8. It’s also essential that you regulate your meds along with your travel- keep them in a pill box in your pocket as well as a supply in your room. I take a double supply with me- one in my purse and one in my travel bag. You can’t miss meds while traveling! That will really miss things up.

9. If you need sleep help to accomplish all of this, that’s fine. Talk with your doctor about using an anti anxiety med like Ativan or Klonopin to sleep or ask about Ambien, Tylenol PM and Benedryl. Alcohol does not work!

These are such simple steps. They don’t cost any money and they are one of the reasons I can travel again. I’m a machine when I travel- I have a schedule that I stick to. I go to my room to recharge. I skip the stimulating stuff even though it can be really hard to do so! I guess I can say I have controlled fun when I travel! It’s a learning process. My next trip to Virginia is going to be a success! I know your husband’s trip can be a success as well!

Julie

PS: If you have the Health Cards Treatment System for Bipolar Disorder, I would definitely make  a travel card! They really help!

Ignoring Bipolar Reality- messing with sleep

Tuesday, August 12th, 2008

Like everyone, I struggle with doing what’s right for myself versus doing what I want to do.

 

I’m paying the price. Sleep is always an issue and lately I haven’t been a good girl when it comes to getting to bed on time. In fact, I’m doing things that are counter intuitive. Eating way too close to bed. Eating foods I’m allergic to- which means body pain that makes it hard to sleep.

 

Drinking too much decaf- eating chocolate and drinking iced tea. They all have caffeine!

 

Watching TV really late- but that’s because of the Olympics!

 

I can make so many excuses. Managing sleep is one of the best ways to manage bipolar disorder. I get tired (no pun intended!) or having to monitor all that I do, but if I don’t I feel like I feel right now.

 

Tired!

 

Julie