Vivid Dreams, Nightmares, and Night Terrors in Bipolar Disorder

Table of ContentsView AllTable of ContentsDreams and Nightmares in Bipolar DisorderNight Terrors in Bipolar DisorderLamictal and Dream AbnormalitiesHow to Cope

Table of ContentsView All

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Table of Contents

Dreams and Nightmares in Bipolar Disorder

Night Terrors in Bipolar Disorder

Lamictal and Dream Abnormalities

How to Cope

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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.

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 GlanceMany people with bipolar disorder experience nightmares and even night terrors. This can become even more troubling when coupled with eitherinsomniaor too much sleep, depending on whether they’re experiencing amanicordepressiveepisode. 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.

At a Glance

Many people with bipolar disorder experience nightmares and even night terrors. This can become even more troubling when coupled with eitherinsomniaor too much sleep, depending on whether they’re experiencing amanicordepressiveepisode. 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.

Nightmares are disturbing, well-remembered dreams that usually incite anxiety and fear. They typically occur later in the evening duringrapid eye movement (REM) sleepand cause a person to wake up abruptly.

Some researchers believe that nightmares in people with bipolar disorder may predict upcoming mood shifts.

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 withmajor depressive disorder(MDD),bipolar disorder, andschizophreniahave nightmares more frequently than the general population.

Press Play for Advice On Dream Interpretation

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.

Night terrorsare also common in people with bipolar disorder.Unlike nightmares, night terrors do not occur during REM sleep.

What Is a Night Terror?

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.

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.

Imagery Rehearsal Therapy to Treat Nightmares With PTSD

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.

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.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 likecaffeineprevent 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.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.

Differentiating Subtypes of Bipolar Disorder

Keep in Mind

How Sleep and Bipolar Disorder Interact

9 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Pancheri C, Verdolini N, Pacchiarotti I, et al.A systematic review on sleep alterations anticipating the onset of bipolar disorder.Eur Psychiatry. 2019;58:45-53. doi:10.1016/j.eurpsy.2019.02.003Steardo L, de Filippis R, Carbone EA, Segura-Garcia C, Verkhratsky A, De Fazio P.Sleep disturbance in bipolar disorder: Neuroglia and circadian rhythms.Front Psychiatry. 2019;10:501. doi:10.3389/fpsyt.2019.00501Akkaoui MA, Lejoyeux M, d’Ortho MP, Geoffroy PA.Nightmares in patients with major depressive disorder, bipolar disorder, and psychotic disorders: A systematic review.J Clin Med. 2020;9(12):3990. doi:10.3390/jcm9123990Baroni A, Hernandez M, Grant MC, Faedda GL.Sleep disturbances in pediatric bipolar disorder: A comparison between bipolar I and bipolar NOS.Front Psychiatry. 2012;3:22. doi:10.3389/fpsyt.2012.00022Comsa M, Anderson KN, Sharma A, Yadav VC, Watson S.The relationship between sleep and depression and bipolar disorder in children and young people.BJPsych Open. 2022;8(1):e27. doi:10.1192/bjo.2021.1076Besag FMC, Vasey MJ, Sharma AN, Lam ICH.Efficacy and safety of lamotrigine in the treatment of bipolar disorder across the lifespan: a systematic review.Ther Adv Psychopharmacol. 2021;11:20451253211045870. Published 2021 Oct 8. doi:10.1177/20451253211045870U.S. Food and Drug Administration.Highlights of prescribing information: Lamictal (lamotrigine).Chaput JP, Dutil C, Featherstone R, et al.Sleep timing, sleep consistency, and health in adults: a systematic review.Appl Physiol Nutr Metab. 2020;45(10 (Suppl. 2)):S232-S247. doi:10.1139/apnm-2020-0032Banno M, Harada Y, Taniguchi M, et al.Exercise can improve sleep quality: a systematic review and meta-analysis.PeerJ. 2018;6:e5172. doi:10.7717/peerj.5172

9 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Pancheri C, Verdolini N, Pacchiarotti I, et al.A systematic review on sleep alterations anticipating the onset of bipolar disorder.Eur Psychiatry. 2019;58:45-53. doi:10.1016/j.eurpsy.2019.02.003Steardo L, de Filippis R, Carbone EA, Segura-Garcia C, Verkhratsky A, De Fazio P.Sleep disturbance in bipolar disorder: Neuroglia and circadian rhythms.Front Psychiatry. 2019;10:501. doi:10.3389/fpsyt.2019.00501Akkaoui MA, Lejoyeux M, d’Ortho MP, Geoffroy PA.Nightmares in patients with major depressive disorder, bipolar disorder, and psychotic disorders: A systematic review.J Clin Med. 2020;9(12):3990. doi:10.3390/jcm9123990Baroni A, Hernandez M, Grant MC, Faedda GL.Sleep disturbances in pediatric bipolar disorder: A comparison between bipolar I and bipolar NOS.Front Psychiatry. 2012;3:22. doi:10.3389/fpsyt.2012.00022Comsa M, Anderson KN, Sharma A, Yadav VC, Watson S.The relationship between sleep and depression and bipolar disorder in children and young people.BJPsych Open. 2022;8(1):e27. doi:10.1192/bjo.2021.1076Besag FMC, Vasey MJ, Sharma AN, Lam ICH.Efficacy and safety of lamotrigine in the treatment of bipolar disorder across the lifespan: a systematic review.Ther Adv Psychopharmacol. 2021;11:20451253211045870. Published 2021 Oct 8. doi:10.1177/20451253211045870U.S. Food and Drug Administration.Highlights of prescribing information: Lamictal (lamotrigine).Chaput JP, Dutil C, Featherstone R, et al.Sleep timing, sleep consistency, and health in adults: a systematic review.Appl Physiol Nutr Metab. 2020;45(10 (Suppl. 2)):S232-S247. doi:10.1139/apnm-2020-0032Banno M, Harada Y, Taniguchi M, et al.Exercise can improve sleep quality: a systematic review and meta-analysis.PeerJ. 2018;6:e5172. doi:10.7717/peerj.5172

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Pancheri C, Verdolini N, Pacchiarotti I, et al.A systematic review on sleep alterations anticipating the onset of bipolar disorder.Eur Psychiatry. 2019;58:45-53. doi:10.1016/j.eurpsy.2019.02.003Steardo L, de Filippis R, Carbone EA, Segura-Garcia C, Verkhratsky A, De Fazio P.Sleep disturbance in bipolar disorder: Neuroglia and circadian rhythms.Front Psychiatry. 2019;10:501. doi:10.3389/fpsyt.2019.00501Akkaoui MA, Lejoyeux M, d’Ortho MP, Geoffroy PA.Nightmares in patients with major depressive disorder, bipolar disorder, and psychotic disorders: A systematic review.J Clin Med. 2020;9(12):3990. doi:10.3390/jcm9123990Baroni A, Hernandez M, Grant MC, Faedda GL.Sleep disturbances in pediatric bipolar disorder: A comparison between bipolar I and bipolar NOS.Front Psychiatry. 2012;3:22. doi:10.3389/fpsyt.2012.00022Comsa M, Anderson KN, Sharma A, Yadav VC, Watson S.The relationship between sleep and depression and bipolar disorder in children and young people.BJPsych Open. 2022;8(1):e27. doi:10.1192/bjo.2021.1076Besag FMC, Vasey MJ, Sharma AN, Lam ICH.Efficacy and safety of lamotrigine in the treatment of bipolar disorder across the lifespan: a systematic review.Ther Adv Psychopharmacol. 2021;11:20451253211045870. Published 2021 Oct 8. doi:10.1177/20451253211045870U.S. Food and Drug Administration.Highlights of prescribing information: Lamictal (lamotrigine).Chaput JP, Dutil C, Featherstone R, et al.Sleep timing, sleep consistency, and health in adults: a systematic review.Appl Physiol Nutr Metab. 2020;45(10 (Suppl. 2)):S232-S247. doi:10.1139/apnm-2020-0032Banno M, Harada Y, Taniguchi M, et al.Exercise can improve sleep quality: a systematic review and meta-analysis.PeerJ. 2018;6:e5172. doi:10.7717/peerj.5172

Pancheri C, Verdolini N, Pacchiarotti I, et al.A systematic review on sleep alterations anticipating the onset of bipolar disorder.Eur Psychiatry. 2019;58:45-53. doi:10.1016/j.eurpsy.2019.02.003

Steardo L, de Filippis R, Carbone EA, Segura-Garcia C, Verkhratsky A, De Fazio P.Sleep disturbance in bipolar disorder: Neuroglia and circadian rhythms.Front Psychiatry. 2019;10:501. doi:10.3389/fpsyt.2019.00501

Akkaoui MA, Lejoyeux M, d’Ortho MP, Geoffroy PA.Nightmares in patients with major depressive disorder, bipolar disorder, and psychotic disorders: A systematic review.J Clin Med. 2020;9(12):3990. doi:10.3390/jcm9123990

Baroni A, Hernandez M, Grant MC, Faedda GL.Sleep disturbances in pediatric bipolar disorder: A comparison between bipolar I and bipolar NOS.Front Psychiatry. 2012;3:22. doi:10.3389/fpsyt.2012.00022

Comsa M, Anderson KN, Sharma A, Yadav VC, Watson S.The relationship between sleep and depression and bipolar disorder in children and young people.BJPsych Open. 2022;8(1):e27. doi:10.1192/bjo.2021.1076

Besag FMC, Vasey MJ, Sharma AN, Lam ICH.Efficacy and safety of lamotrigine in the treatment of bipolar disorder across the lifespan: a systematic review.Ther Adv Psychopharmacol. 2021;11:20451253211045870. Published 2021 Oct 8. doi:10.1177/20451253211045870

U.S. Food and Drug Administration.Highlights of prescribing information: Lamictal (lamotrigine).

Chaput JP, Dutil C, Featherstone R, et al.Sleep timing, sleep consistency, and health in adults: a systematic review.Appl Physiol Nutr Metab. 2020;45(10 (Suppl. 2)):S232-S247. doi:10.1139/apnm-2020-0032

Banno M, Harada Y, Taniguchi M, et al.Exercise can improve sleep quality: a systematic review and meta-analysis.PeerJ. 2018;6:e5172. doi:10.7717/peerj.5172

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