AAPEL
Borderline personality disorder and insomnia, nightmares or hypersomnia
 Introduction:
Connection between borderline personality,and insomnia, sleeplessness. On the face of it, there is no doubt about links between both of them. Most of people with mental health problem are dealing with insomnia. I have also read an hypothesis about some link between insomnia and manic episode in BPD but I really have no opinion. You will find on the last part of this document our vision which we hope comprehensive and listening to the suffering
Meme page en Francais / Same page in french
Data, studies
What they say ?
Aapel view
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Data, studies (statistics, prevalence, comorbidity, co-occurency)
* Lahmeyer HW, Reynolds CF 3rd, Kupfer DJ, King R. - Department of Psychiatry, University of Illinois, Chicago
1989 J Clin Psychiatry. - Biologic markers in borderline personality disorder: a review.
"Many patients with Axis II BPD have coexisting Axis I diagnoses of which depression is the most commonly reported. ...some markers, particularly EEG sleep, are not only abnormal in BPD, but also appear to discriminate Axis I depression from other Axis I codiagnoses.

* Schramm E, Hohagen F, Kappler C, Grasshoff U, Berger M. - Psychiatric University Clinic of Freiburg, Germany.
1995 Acta Psychiatr Scand - Mental comorbidity of chronic insomnia in general practice attenders using DSM-III-R.
The major aim of this study was to investigate links between chronic insomnia and mental and personality disorders using the DSM-III-R classification
Fifty percent (50%) of people with insomnia had at least one additional current Axis I or II diagnosis

* Benson KL, King R, Gordon D, Silva JA, ... - Department of Psychiatry, VA Medical Center, Palo Alto, CA
1990 J Affect Disord - Sleep patterns in borderline personality disorder.
Rapid eye movement. Borderlines were different from normal controls in some aspects of sleep architecture; they had less total sleep, more stage 1 sleep, and less stage 4 sleep

* Reynolds CF 3rd, Soloff PH, Kupfer DJ, ...
1985 Psychiatry Res - Depression in borderline patients: electroencephalographic (EEG) sleep studies
A convergence of nosologic and EEG sleep data is suggested, and supports the concept of a close relationship between criteria-defined borderline personality disorder and affective illness.

* Leskin GA, Woodward SH, Young HE, Sheikh JI. - VA Palo Alto Health Care System CA 94025, USA
2OO2 J Psychiatr Res - Effects of comorbid diagnoses on sleep disturbance in PTSD.
OBJECTIVE: Patients with post-traumatic stress disorder (PTSD) are frequently diagnosed with other psychiatric comorbid conditions. Groups consisted of patients diagnosed with lifetime PTSD and with current comorbid panic disorder, major depressive disorder, generalized anxiety disorder, and alcohol dependence
RESULTS: Patients diagnosed with PTSD/panic disorder reported a significantly greater proportion of nightmare complaints (96%) and insomnia (100%) compared with the other comorbid groups.

* Lansky MR, Bley CR. - UCLA School of Medicine.
1990 Bull Menninger Clin - Exploration of nightmares in hospital treatment of borderline patients.
Early familial trauma, prominent in the latent content of the nightmares, predisposed these patients to adult dysfunction or to a maladaptive response to subsequent trauma

* Mayer G, Leonhardt E. - Hephata-Klinik, Schwalmstadt-Treysa, Deutschland.
1996 Wien Med Wochenschr. - Performance and personality of patients with hypersomnia
"5 groups of patients with hypersomnia (narcolepsy, posttraumatic, psychophysiologic, idiopathic hypersomnia and circadian sleep-wake disorders) were tested with a battery of psychometric tests
Patients with circadian sleep-wake disorders display the most striking personality disorders, which are most probably sequelae of their strong disease-dependent impairment. The degree of personality disorder seems to be strongly dependent on the duration of the hypersomnias"

* Silberman EK, Sullivan JL.
1984 Psychiatr Clin North Am. - Atypical depression.
"Atypical depressions are those characterized by high levels of phobic anxiety or by reversed vegetative symptoms such as hypersomnia and hyperphagia"
 


Insomnia and BPD, what they say
"Significant abnormalities in REM (Rapid eye movement) sleep, more rapid onset, more intense" (Kathi Stringer, “Personality Disorders”, www.toddlertime.com)

"Sleep is abnormal" (Leland M. Heller, MD, “Dr leland heller discusses BPD”, biologicalunhappiness.com)

"Borderline people experience chronic feelings of emptiness and boredom. This will manifest itself in sleeplessness (insomnia), loss of appetite, unplanned road trips, and sexual affairs" (O'Connor, T.R. ,“Understanding Borderline Personality Disorder and Obsessive”, MegaLinks in Criminal Justice)


Aapel view of insomnia and Borderline Personality Disorder
Here is our feeling

Is there some link between BPD and insomnia (or hypersomnia) ?
Yes, but we can't diagnose a borderline disorder because you have sleep problems

Is it normal to have sleep problems and sometimes insomnia ?
Are you kidding ? As a bpd, you can have dysphoric episode and or depression, it is then logical to have sleep problems. You can have euphoric episodes, it is then normal to have sleep problems. You can be anxious, it is then normal to have sleep problems, etc...

Is there some proof about sleep problems and BPD ?
The answer seems yes, read data above

What can I do to reduce such problems ?
There is no miracle, but the answer is "treatment". If you are "less borderline", then you will have less sleeping problems

Is there some drugs to help ?
BPD medication as usual will help you, because medication are here to decrease mood swings, anxiety, ...

In the opposte, is there some sleep problems induced by medication ?
Yes but it depends. This could be sleep problems especially during the first days after trying a new medication or after stopping it. Ask your doctor

Is sleep, an indicator ?
Absolutely, it is then important to talk about any changes to your doctor / therapist

Please read BPD and somatoform disorders

AAPEL - Back to BPD summary page
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Warning:
All the information in this site is aimed at helping people understand a "rather particular" and puzzling kind of disease
But more especially, to support everyone affected by it, sick or not.  In any case, it is ESSENTIAL to see a therapist who specialises in this field they can confirm or give an alternative diagnosis
The name of what you’ve got doesn’t matter so much, getting the right treatment for the right patient does

last update august 2007
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