Can chronic neuroleptic treatment promote sleep disturbances in elderly schizophrenic patients?

The objective of the present study was to evaluate the relationship between the sleep–wake behaviour and neurological impairments among mentally retarded people. The sleep–wake behaviour of 293 mentally retarded subjects living in a rehabilitation center was studied by a standardized observation protocol carried out by trained staff members. The protocol consisted of brief check‐ups of the subjects’ sleep–wake status at 20‐min intervals for five randomly chosen 24‐h periods during 4 months. From the raw data five sleep–wake behaviour variables were formed. The data concerning the subject characteristics (age, body mass index (BMI), gender, degree of mental retardation, presence of locomotor disability, that of epilepsy, blindness or deafness and the usage of psychotropic medications) were collected from the medical records. Two main findings emerged: (1) severe locomotor disablity, blindness and active epilepsy were found to be independent predictors of increased daytime sleep and increased number of wake–sleep transitions and (2) the subjects with a combination of two or all three of these impairments had a significantly more fragmented and abnormally distributed sleep than those with none or milder forms of these impairments. Age, BMI, degree of mental retardation and the studied medications played a minor role in the sleep disturbances of the study population. Finally, deafness was not found to be associated with any of the measured sleep–wake variables.

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“…1991). However, chronic usage of neuroleptics has also been proposed to lead to insomnia‐like symptoms (Staedt et al . 2000).…”

Section: Discussionmentioning

confidence: 99%

Neurological impairments and sleep–wake behaviour among the mentally retarded

Lindblom

Heiskala

Kaski³

et al. 2001

Journal of Sleep Research

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“…In all 10 patients, insomnia related to limb movement was detected, consistent with a relationship between long-term neuroleptic therapy and PLMD occurrence. 27 However, in a study of late-life psychosis, only a small proportion (7 of 52 patients) had a myoclonus index greater than 5, which would qualify for a diagnosis of PLMD. Furthermore, there was no significant difference in age, neuroleptic use, or duration of neuroleptic treatment between those with PLMD and those without, thus suggesting that the role of APs in PLMD needs to be further investigated.…”

Section: Linksmentioning

confidence: 99%

Schizophrenia and sleep disorders: links, risks, and management challenges

Kaskie¹,

Graziano²,

Ferrarelli³

2017

NSS

155

114

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Schizophrenia is a major psychiatric disorder that has a massive, long-lasting negative impact on the patients as well as society. While positive symptoms (i.e., delusions and hallucinations), negative symptoms (i.e., anhedonia, social withdrawal), and cognitive impairments are traditionally considered the most prominent features of this disorder, the role of sleep and sleep disturbances has gained increasing prominence in clinical practice. Indeed, the vast majority of patients with schizophrenia report sleep abnormalities, which tend to precede illness onset and can predict an acute exacerbation of psychotic symptoms. Furthermore, schizophrenia patients often have a comorbid sleep disorder, including insomnia, obstructive sleep apnea, restless leg syndrome, or periodic limb movement disorder. Despite accumulating data, the links between sleep disorders and schizophrenia have not been thoroughly examined, in part because they are difficult to disentangle, as numerous factors contribute to their comorbidity, including medication status. Additionally, sleep disorders are often not the primary focus of clinicians treating this population, despite studies suggesting that comorbid sleep disorders carry their own unique risks, including worsening of psychotic symptoms and poorer quality of life. There is also limited information about effective management strategies for schizophrenia patients affected by significant sleep disturbances and/or sleep disorders. To begin addressing these issues, the present review will systematically examine the literature on sleep disorders and schizophrenia, focusing on studies related to 1) links between distinct sleep disorders and schizophrenia; 2) risks unique to patients with a comorbid sleep disorder; and 3) and management challenges and strategies.

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“…Although much of this use is considered off label, the use of a sedating antipsychotic is common in clinical practice. 58 In a study of 86 inpatients (mean age = 61.4 years) being treated for schizophrenia with antipsychotic medications, the proportion of patients who experienced improved subjective sleep quality was significantly higher in elderly subjects who received atypical antipsychotics as compared to conventional medications. 59 Side effects of chronic neuroleptic treatment in elderly schizophrenic patients may actually worsen sleep, however, by causing nocturnal myoclonus.…”

Section: Antipsychotic Medicationsmentioning

confidence: 99%

Pharmacologic Treatment of Disturbed Sleep in the Elderly

Salzman

2008

Harvard Review of Psychiatry

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Disturbed sleep is common in the elderly, who, as a group, take a disproportionately large number of hypnotic medications. Benzodiazepine hypnotics, as well as the newer benzodiazepine receptor agonists, are the primary treatments for these late-life sleep disorders and are effective and safe when used within recommended prescribing guidelines. The elderly also receive other psychiatric medications to induce sleep, although these are off-label uses not well supported by research literature. There is also no literature support for the use of over-the-counter sleep preparations, although both melatonin and a melatonin receptor agonist appear to be moderately effective and safe. Prescribing guidelines for the elderly continue to emphasize short-term, low-dose use, with short-half-life medications. Hypnotic drugs should be used in conjunction with nonmedication treatments, including appropriate sleep hygiene practice, and treatment of other medical or psychiatric causes of disturbed sleep.

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Can chronic neuroleptic treatment promote sleep disturbances in elderly schizophrenic patients?

Cited by 20 publications

References 33 publications

Neurological impairments and sleep–wake behaviour among the mentally retarded

Neurological impairments and sleep–wake behaviour among the mentally retarded

Schizophrenia and sleep disorders: links, risks, and management challenges

Pharmacologic Treatment of Disturbed Sleep in the Elderly

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