Current Sleep Guidelines

The recommended amount of sleep each night (per 24 hours) for the general population is:
13-18 years – 8 to 10 hours each night. (American Academy of Sleep Medicine, Paruhti 2016)
18 years and older – at least 7 hours per night, with some younger adults requiring over 9 hours per night on a regular basis. (American Academy of Sleep Medicine, Watson 2015)

Recommended amount of sleep each night for people with bipolar disorder:

Disordered sleep (either too little or too much) seems to have a more immediate impact on bipolar-related indicators than it does on other conditions such as hypertension or diabetes. Among patients with bipolar disorder, sleep disturbance is the most common prodrome of mania and the sixth most common prodrome of depression. (Harvey et al, 2009)

Benefits/Risks associated with meeting/not meeting Sleep Guidelines

Benefits of meeting sleep guidelines (General Population):

For 13-18 year olds: Sleeping the number of recommended hours on a regular basis is associated with better health outcomes including: improved attention, behavior, learning, memory, emotional regulation, quality of life, and mental and physical health.

Potential harms associated with not meeting sleep guidelines (General Population):

For 13-18 year olds: Regularly sleeping fewer than the number of recommended hours is associated with attention, behavior, and learning problems. Insufficient sleep also increases the risk of accidents, injuries, hypertension, obesity, diabetes, and depression. Insufficient sleep in teenagers is associated with increased risk of self-harm, suicidal thoughts, and suicide attempts. (Paruhti 2016)

For adults 18+: Sleeping less than 7 hours per night on a regular basis is associated with adverse health outcomes, including weight gain and obesity, diabetes, hypertension, heart disease and stroke, depression, and increased risk of death. Sleeping less than 7 hours per night is also associated with impaired immune function, increased pain, impaired performance, increased errors, and greater risk of accidents. (Watson 2015)

Benefits of meeting sleep guidelines (Bipolar Disorder):

Preservation of stable sleep–wake cycles seem to be key to the maintenance of stability in BD, indicating the crucial role of circadian rhythms in this syndrome. (Steardo et al, 2021). Meeting (or even exceeding in certain cases) the recommended hours of nightly sleep may reduce the risk of a manic episode after a period of poor sleep.

Potential harms associated with not meeting sleep guidelines (Bipolar Disorder):

The symptom most widespread in BD is insomnia, followed by excessive daytime sleepiness, nightmares, difficulty falling asleep or maintaining sleep, poor sleep quality, sleep talking, sleep walking, and obstructive sleep apnea. (Steardo et al, 2021)

Gender and bipolar subtype may increase vulnerability to high mood following sleep deprivation. (Lewis et al, 2017)

Why measure sleep objectively (with sensors)?

Kaufman et al (2019) found that “inaccuracy in reports of sleep duration was associated with lower functioning among bipolar disorder (BD) patients. Better identifying discrepancies in reports of sleep duration in clinical practice could help in more efficient monitoring and management of BD symptoms.

Definitions for ‘short sleep’ or ‘long sleep’ in General Population:

Thresholds to classify short or long sleep are not well established in adolescents or adults, and few studies have parsed the specific risk associated with one-hour increments of sleep duration. (Watson 2015)

In 13-18 year olds: Research suggests a U-shape curve to sleep among adolescents in which too little or too much sleep is associated with mental health problems and substance abuse.

Fitzgerald et al (2011) found that teens sleeping ≤ 5 hours and ≥ 10 hours had more suicidal attempts than those sleeping 8 hours per night.

In adults 18+: The threshold for short sleep varies across research studies from 5–7 hours, with the majority using 6 hours. Some data also demonstrate increased risk associated with sleep duration longer than 8–9 hours. (Watson 2015)