Managing Sleep

I know a ton of us, especially right now when we’re under lockdown, are struggling to get a good night’s kip. How can a lack of sleep affect us? I’ll also look at some tips and advice that have helped me along the way.

Why is sleep so important?

Sleep refreshes us, it keeps us going. But when you live with Bipolar disorder, or any mental health condition really, a lack of sleep can have a major impact. Sleep disturbance is very common if you live with bipolar disorder. Disrupted sleep is a symptom of mania, but it an also lead to manic and hypomanic episodes. Studies have shown that 25 – 65% of people with bipolar, who had a manic episode, had experienced sleep disruption before the episode.

Breaking down the different types of sleep disturbances

Insomnia – is having problems getting to sleep, and staying asleep, or not sleeping enough. It’s a common problem for many people with mental health problems. Hypomania and mania often lead to insomnia.

Hypersomnia – This is the total opposite of insomnia. Over sleeping affects one third of people with bipolar disorder. It often happens during periods depression, where all we want to do is sleep.

Irregular sleep-wake schedule – This is when your sleep routine goes out the window. The irregular cycle can interfere with treatment.

My own experience

I struggle with insomnia, a lot. It’s incredibly frustrating, and to top it off, for me it often leads to mania. If my sleep is disrupted for more then three days in a row (say, I get 2-3 hours a night) I can become very ill, very quickly. Not sleeping is a major trigger I’ve realised over the years and I have to keep an eye on it, and try my best to get a good night’s sleep. I’m also the type of person that when I’m depressed, I feel absolutely knackered all the time. All I want to do is sleep, and even when I get a good 8 hours, I still feel exhausted.

So what have I learnt to help me sleep?

Get some exercise – Honestly knackering yourself out can help knock you out for the night. Tiring out your body through exercise lifts your mood – and helps you sleep. It doesn’t always mean going for a run, or doing aerobics at home. Sometimes I just have a dance party in my lounge – why not! Just don’t exercise a few hours before bed, because it’s too energising and will keep you up. I realise not everyone can exercise all the time when you live with mental illness. Even a gentle walk is better than nothing.

Avoid screen time – Blue screen is baaaad for sleep. Try to stay away from the television, your phone, computer or laptop, at least an hour before you go to bed. Instead, start your bedtime routine. Read a book, even make a plan for the following day.

Routine – When I was first diagnosed with bipolar disorder, my psychologist wouldn’t stop banging on about sleep hygiene. What this means is having a solid evening routine you stick to. It helps your mind relate certain tasks and sensory experiences to preparing for sleep. Wahing your face, brushing your teeth, moisturising your body are all a great start. Try incorporating calming hobbies and interests into your routine, such as reading a book in bed or in a quiet corner of the room you sleep in. Make sure you go to bed at a regular time at night, and wake up the same time every morning. I tend to have a ‘night off’ from my routine once a week on a Saturday night, but go straight back to it the next day.

Reflect and Plan – Keep a journal and write down what you’ve done that day. It can help you sort through your thoughts and focus on something that might be worrying you, instead of those worries popping up when you’re already in bed, trying to sleep. Writing is cathartic, and can help you understand your anxieties, and work through them. Listing on paper what you have to do tomorrow, can stop you fixating on those plans when you’re laying in bed.

Avoid naps – If you can, or keep them short if you need one. I love a good nap, but I know if I nap in the afternoon or evening, I won’t sleep at night!

Keep your bedroom for sleeping – Limit watching television, or working on your laptop. Try keeping a tidy bedroom that feels relaxing to be in.

Avoid alcohol and caffeine

Get up– It might seem counter intuitive, but if you can’t sleep (say after 30 minutes) get out of bed and try doing something relaxing. Otherwise it’s frustrating to stay in bed worrying why you can’t sleep. Even if you’ve been up during the night, try to get up at your regular time.

I hope some of these tips help you to get a better night’s sleep. If you’re really struggling to sleep, go and see your GP or psychiatrist, who might be able to give you additional support and further treatment.

Tactile Hallucinations

For the past few months I haven’t been sleeping properly. It has taken over all aspects of my life. Most notably, here on my blog. I haven’t blogged for months, because I simply haven’t had the concentration span to finish a post.

I’ve been irritable and moody. My short temper is now just a very blunt fuse. Every little annoyance is blown way out of proportion. I’m exhausted all the time. I walk around in a haze not really able to focus.

I have tried everything I can think of to try and sleep. I’ve listened to everyone’s opinions and well meaning advice. I’ve stopped drinking. Cut down on caffeine. I’m exercising more. I’ve even tried meditating, which for me is unheard of. Nothing has worked.

You’re probably thinking,

“Just go to the doctor already!”

You see, I’ve been putting it off. I knew if I went I’d have to talk about the main cause of why I can’t sleep. Everyday for months, I’ve felt like something is crawling over my skin. Mostly I can ignore it during the day, I’m moving around, busy with work, or socialising. At night though the feeling is hellish. Laying in the dark everything feels more intense, more real. There’s a crawling, ticklish feeling over a toe. I slap it with the palm of my hand. A few seconds later I feel something on my leg, my arm, even my face and neck. It goes on and on for hours.

I’ve found with much of the psychotic symptoms I’ve displayed, like hearing voices, my first reaction is to deny, deny, deny. I think, there must be a mosquito in my room. Countless times I’ve got out of bed, turned the light on and scanned the room for the little bugger. I never find it. There isn’t anything to find. This week I’ve managed to face it head on and go and see my GP. I wasn’t going to mention it but the doctor very astutely recognised I was holding back the real reason I was having so much trouble sleeping. Please can we have more doctors like her, who are attentive, empathetic and make time for their patients! I need to go back and sort out a referral to see a psychiatrist, because at the moment I don’t have one. This was after I was discharged in the same appointment where I admitted having suicidal thoughts only hours earlier.

As I’m writing this I can feel a crawling sensation on my thigh. I’m wearing shorts so I can see the skin where there feels like there should be a bug. I’m looking at it and still the sensation lingers on. It’s freaky as fuck. I’m desperately wishing for it to stop now.

I worry intensely about going to bed, because I know I’ll be kept awake by these phantom insects. Every night I think to myself,

“This is the night where it stops. This is the night where I can finally sleep.”

But every night it’s the same old frustrating routine.

This is very new to me, and I’m still coming to terms with it. Even though I’ve experienced psychosis before, and I’m open about my experiences, I’ve still found myself nervously talking to my partner and family about this new symptom. I still worry how people will look at me when I explain the experience. I want to know more people that have tactile hallucinations, have discussions and learn from one another, so get in touch in the comments or message me!