Journal ArticleDOI
Sleep disturbances in patients with schizophrenia : impact and effect of antipsychotics.
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TLDR
It appears possible that the high-potency drugs exert their effects on sleep in schizophrenic patients, for the most part, in an indirect way by suppressing stressful psychotic symptomatology.Abstract:
Difficulties initiating or maintaining sleep are frequently encountered in patients with schizophrenia. Disturbed sleep can be found in 30–80% of schizophrenic patients, depending on the degree of psychotic symptomatology. Measured by polysomnography, reduced sleep efficiency and total sleep time, as well as increased sleep latency, are found in most patients with schizophrenia and appear to be an important part of the pathophysiology of this disorder. Some studies also reported alterations of stage 2 sleep, slow-wave sleep (SWS) and rapid eye movement (REM) sleep variables, i.e. reduced REM latency and REM density. A number of sleep parameters, such as the amount of SWS and the REM latency, are significantly correlated to clinical variables, including severity of illness, positive symptoms, negative symptoms, outcome, neurocognitive impairment and brain structure. Concerning specific sleep disorders, there is some evidence that schizophrenic patients carry a higher risk of experiencing a sleep-related breathing disorder, especially those demonstrating the known risk factors, including being overweight but also long-term use of antipsychotics. However, it is still unclear whether periodic leg movements in sleep or restless legs syndrome (RLS) are found with a higher or lower prevalence in schizophrenic patients than in healthy controls. There are no consistent effects of first-generation antipsychotics on measuresof sleep continuity and sleep structure, including the percentage of sleep stages or sleep and REM latency in healthy controls. In contrast to first-generation antipsychotics, the studied atypical antipsychotics (clozapine, olanzapine, quetiapine, risperidone, ziprasidone and paliperidone) demonstrate a relatively consistent effect on measures of sleep continuity, with an increase in either total sleep time (TST) or sleep efficiency, and individually varying effects on other sleep parameters, such as an increase in REM latency observed for olanzapine, quetiapine and ziprasidone, and an increase in SWS documented for olanzapine and ziprasidone in healthy subjects. The treatment of schizophrenic patients with first-generation antipsychotics is consistently associated with an increase in TST and sleep efficiency, and mostly an increase in REM latency, whereas the influence on specific sleep stages is more variable. On the other hand, withdrawal of such treatment is followed by a change in sleep structure mainly in the opposite direction, indicating a deterioration of sleep quality. On the background of the rather inconsistent effects of first-generation antipsychotics observed in healthy subjects, it appears possible that the high-potency drugs exert their effects on sleep in schizophrenic patients, for the most part, in an indirect way by suppressing stressful psychotic symptomatology. In contrast, the available data concerning second-generation antipsychotics (clozapine, olanzapine, risperidone and paliperidone) demonstrate a relatively consistent effect on measures of sleep continuity in patients and healthy subjects, with an increase in TST and sleep efficiency or a decrease in wakefulness. Additionally, clozapine and olanzapine demonstrate comparable influences on other sleep variables, such as SWS or REM density, in controls and schizophrenic patients. Possibly, the effects of second-generation antipsychotics observed on sleep in healthy subjects and schizophrenic patients might involve the action of these drugs on symptomatology, such as depression, cognitive impairment, and negative and positive symptoms. Specific sleep disorders, such as RLS, sleep-related breathing disorders, night-eating syndrome, somnambulism and rhythm disorders have been described as possible adverse effects of antipsychotics and should be considered in the differential diagnosis of disturbed or unrestful sleep in this population.read more
Citations
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Journal ArticleDOI
European guideline for the diagnosis and treatment of insomnia
Dieter Riemann,Chiara Baglioni,Claudio L. Bassetti,Bjørn Bjorvatn,Leja Dolenc Groselj,Jason Ellis,Colin A. Espie,Diego Garcia-Borreguero,Michaela D. Gjerstad,Marta Gonçalves,Elisabeth Hertenstein,Markus Jansson-Fröjmark,Poul Jennum,Damien Leger,Christoph Nissen,Liborio Parrino,Tiina Paunio,Dirk Pevernagie,Johan Verbraecken,Hans G. Weeß,Adam Wichniak,Irina Zavalko,Erna S. Arnardottir,Oana Claudia Deleanu,Barbara Strazisar,Marielle Zoetmulder,Kai Spiegelhalder +26 more
TL;DR: In this article, a European guideline for the diagnosis and treatment of insomnia was developed by a task force of the European Sleep Research Society, with the aim of providing clinical recommendations for the management of adult patients with insomnia.
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Sleep and circadian rhythm disruption in psychiatric and neurodegenerative disease
TL;DR: It is proposed that brain disorders and abnormal sleep have a common mechanistic origin and that many co-morbid pathologies that are found in brain disease arise from a destabilization of sleep mechanisms.
European guideline for the diagnosis and treatment of insomnia
Dieter Riemann,Chiara Baglioni,Claudio L. Bassetti,Bjørn Bjorvatn,Leja Dolenc Groselj,Jason Ellis,Colin A. Espie,Diego Garcia-Borreguero,Michaela D. Gjerstad,Marta Gonçalves,Elisabeth Hertenstein,Markus Jansson-Fröjmark,Poul Jennum,Damien Leger,Christoph Nissen,Liborio Parrino,Tiina Paunio,Dirk Pevernagie,Johan Verbraecken,Hans-Guenter Weess,Adam Wichniak,Irina Zavalko,Erna S. Arnardottir,Oana-Claudia Deleanu,Barbara Strazisar,Marielle Zoetmulder,Kai Spiegelhalder +26 more
TL;DR: This European guideline for the diagnosis and treatment of insomnia was developed by a task force of the European Sleep Research Society, with the aim of providing clinical recommendations for the management of adult patients with insomnia.
Journal ArticleDOI
Poor sleep as a potential causal factor in aggression and violence.
TL;DR: An overview of existing literature on the relation between poor sleep and aggression, irritability, and hostility is given and individual variation within these neurobiological systems may be responsible for amplified aggressive responses induced by sleep loss in certain individuals.
Journal ArticleDOI
Sleep, insomnia, and depression
TL;DR: The question is: can the early and adequate treatment of insomnia prevent depression, and current understanding about sleep regulatory mechanisms with knowledge about changes in physiology due to depression are linked.
References
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Journal ArticleDOI
Effects of Selected Phenothiazines on REM Sleep in Schizophrenics
TL;DR: These studies have not consistently demonstrated marked differences in REM sleep between schizophrenics and normal subjects, and several recent studies have suggested, however, that Stage 4 or delta sleep may be decreased in schizophrenia 4 and depressive psychosis.
Journal ArticleDOI
Modification of dream content after preferential blockade of mesolimbic and mesocortical dopaminergic systems.
Jean-Michel Gaillard,Ali Moneme +1 more
TL;DR: The idea of a correlation between the activity of the mesolimbic and/or mesocortical dopaminergic systems and the expression of emotions and drives in mental contents associated with REM-sleep is supported.
Journal ArticleDOI
Relationship between delta activity during all-night sleep and negative symptoms in Schizophrenia: A Preliminary Study
Naofumi Kajimura,Masaaki Kato,Teruo Okuma,Masanori Sekimoto,Tsuyoshi Watanabe,Kiyohisa Takahashi +5 more
Journal ArticleDOI
Sleep disorder and psychobiological symptomatology in male psychiatric outpatients and male nonpatients.
TL;DR: It is suggested that sleep disturbance might be a useful clinical clue to previously unsuspected psychiatric and physical illness.