Insomnia in Patients with Borderline Personality Disorder

Abstract

Objective Both sleep disorders and BPD are prevalent in the population, and one is often a comorbidity of the other. This narrative review aims to assess contemporary literature and scientific databases to provide the current state of knowledge about sleep disorders in patients with borderline personality disorder (BPD) and clinical suggestions for managing sleep disorders in BPD patients and future research direction. Methods Articles were acquired via PubMed and Web of Science, and papers published between January 1980 and October 2020 were extracted. Authors made a series of literature searches using the keywords: Sleep problems, Insomnia, Nightmares, Obstructive sleep apnea, Borderline personality disorder. The inclusion criteria were: published in peer-reviewed journals; studies in humans; or reviews on the related topic; English language. The exclusion criteria were: abstracts from conferences; commentaries; subjects younger than 18 years. After an inspection of the full texts, 42 papers from 101 were selected. Secondary documents from the reference lists of the primary designated papers were searched, assessed for suitability, and included. In total, 71 papers were included in the review process. Results Sleep disturbance is common among patients with BPD. Nevertheless, the number of investigations is limited, and the prevalence differs between 5–45%. Studies assessing objective changes in sleep architecture in BPD show inconsistent results. Some of them identify REM sleep changes and a decrease in slow-wave sleep, while other studies found no objective sleep architecture changes. There is also a higher prevalence of nightmares in patients with BPD. Untreated insomnia can worsen BPD symptoms via interference with emotional regulation. BPD itself seems to influence the subjective quality of sleep significantly. Proper diagnosis and treatment of sleep disorders in patients with BPD could lead to better results in therapy. Psychotherapeutic approaches can improve both sleep disorders and BPD symptoms. Conclusion Recognising and managing sleep disorders in patients with BPD may help alleviate the disorder’s symptoms. Treatment of people with BPD may be more effective if the treatment plan explicitly addresses sleep problems. Further research is needed to reach reliable conclusions.

Effects of BPD tendencies and subjective well-being on NSSI in adolescents with PTSD

“…One study reported that compared with non-BPD individuals with NSSI, BPD individuals with NSSI are more prone to severe depression and suicidal behavior ( 48 ). Some studies have noted that people with BPD have a higher risk of NSSI than the general population ( 49 , 50 ), and there is an interaction between BPD and NSSI ( 51 ). Our analysis showed that BPD tendencies are significantly positively correlated with NSSI in PTSD students, which further confirms that BPD tendencies can increase the risk of NSSI.…”

Interventions to improve the sleep quality of adults with personality disorder: A systematic review

“…People diagnosed with personality disorder (PD) commonly describe poor quality sleep, with evidence pointing to a prevalence of insomnia of around 70% (Selby, 2013; Van Veen et al, 2017; Vanek et al, 2021). Because people with PD (also frequently referred to as complex emotional needs [CEN]) make up 30%–50% of all patients in secondary mental health services, sleep disturbance in PD is a common presentation in the psychiatric clinic (Newton‐Howes et al, 2010).…”

Guided internet-based cognitive behavioral therapy for insomnia in patients with borderline personality disorder: Study protocol for a randomized controlled trial

“…Disturbed sleep is thus a highly important factor in BPD severity and recovery. BPD patients often experience severe sleep disturbances ( DeShong and Tucker, 2019 ; Schredl et al, 2012 ; Vanek et al, 2021 ). A recent meta-analytic review showed both subjective (e.g.…”