Excessive Daytime Sleepiness in  Schizophrenia: A Naturalistic  Clinical Study

Sharma, Podila Satya Venkata Narasimha; Dikshit, Reetika; Shah, Nilesh; Karia, Sagar; A, De Sousa

doi:10.7860/jcdr/2016/21272.8627

Cited by 11 publications

(7 citation statements)

References 21 publications

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“… 13 Among those diagnosed with schizophrenia, poor sleep quality has been observed in the majority of patients. 14 In patients with chronic schizophrenia, sleep continuity and architecture are significantly different from healthy populations – something that has also been observed in young patients with childhood-onset schizophrenia. Furthermore, sleep disturbances appear to be related to symptom severity.…”

Section: Introductionmentioning

confidence: 97%

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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Section: Introductionmentioning

confidence: 97%

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

Kaskie¹,

Graziano²,

Ferrarelli³

2017

NSS

155

114

View full text Add to dashboard Cite

show abstract

“…With respect to the second subjective sleep inventory that measured daytime sleepiness, the long-term patients with schizophrenia scored below the generally used cut-off score of 9 [ 46 ], meaning that they did not suffer from daytime sleepiness in comparison with the healthy norm. With respect to daytime sleepiness, the ongoing pharmacological treatment of the patients did not seem to increase their sleepiness, as might have been expected, because sleepiness has often been mentioned as a side effect [ 55 , 56 ]. Nevertheless, in the future, the pharmacological treatment may be further improved so that long-term male and female patients with schizophrenia, on average, score close to 0 on the ESS instead of around the value of 6 at present.…”

Section: Discussionmentioning

confidence: 99%

Pharmacological Treatment for Long-Term Patients with Schizophrenia and Its Effects on Sleep in Daily Clinical Practice: A Pilot Study

et al. 2018

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Background: Pharmacological treatment is still the key intervention in the disease management of long-term patients with schizophrenia; however, how it affects sleep and whether gender differences exist remains unclear. Methods: Forty-six long-term outpatients with schizophrenia entered the study. The numbers of antipsychotics, sleep medications, antidepressants, and anxiolytics were analyzed. Moreover, all patients were tested using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Correlation analyses were conducted between the medication used and the scores on the two subjective sleep inventories. Results: A large variability, ranging from 0 to 8, in the total number of psychiatric drugs per person was found between the patients. Despite ongoing pharmacological treatment, the patients scored high on the PSQI, but not on the ESS; this indicates that they report problems with sleep, but not with daytime sleepiness. A significant positive correlation between the use of antipsychotics and the ESS score, but not the PSQI score, was found; moreover, no gender differences were found. Conclusions: A large variability exists in the pharmacological treatment of long-term patients with schizophrenia. To date, patients’ sleep problems have been insufficiently treated, and gender differences have not been adequately accounted for in the pharmacological treatment of schizophrenia. More and larger international clinical studies are warranted to verify the findings of the present preliminary pilot study before any firm conclusions can be drawn and before any changes to the drug treatment of male and female patients with schizophrenia can be recommended.

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“…Utilizing the PSQI was advantageous because its wide usage allowed comparison of present with previous findings. However, the PSQI does not capture daytime sleepiness or napping which are commonly reported among SMI populations ( 43 ). Further, future studies are needed that utilize scalable measures of both subjective and objective measures of sleep, capturing both trait and state features, to ascertain a richer picture of sleep health in this population.…”

Section: Discussionmentioning

confidence: 99%

Sleep health among people with severe mental ill health during the COVID-19 pandemic: Results from a linked UK population cohort study

et al. 2022

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ObjectivesSleep problems are a transdiagnostic feature of nearly all psychiatric conditions, and a strong risk factor for initial and recurrent episodes. However, people with severe mental ill health (SMI) are often excluded from general population surveys, and as such the extent and associates of poor sleep in this population are less well understood. This study explores sleep health in an SMI sample during the COVID-19 pandemic, using multiple regression to identify risk factors, including daily routine, wellbeing and demographics.MethodsAn existing cohort of people with an SMI diagnosis were sampled. Participants were invited to complete a self-report survey about their health and the impacts of COVID-19 and associated public health measures. Sleep duration, efficiency, and quality were measured using items from the Pittsburgh Sleep Quality Index (PSQI).ResultsTwo hundred forty-nine adults (aged 21–84 years) completed the survey. Mean sleep duration and efficiency were similar to general population estimates, at 7 h 19 min and 78%, respectively. However, 43% reported “bad” sleep quality that was associated with being younger in age as well as disturbed routine and declined wellbeing. Indeed, 37% reported a disturbed routine during the pandemic.ConclusionsHigh estimates of perceived poor sleep quality in the SMI population align with previous findings. Supporting people with SMI to maintain routine regularity may work to protect sleep quality and wellbeing. Future research should more closely examine sleep health in people with SMI, using accessible and scalable measures of objective and subjective sleep, examining longitudinal trends.

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Excessive Daytime Sleepiness in Schizophrenia: A Naturalistic Clinical Study

Cited by 11 publications

References 21 publications

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

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

Pharmacological Treatment for Long-Term Patients with Schizophrenia and Its Effects on Sleep in Daily Clinical Practice: A Pilot Study

Sleep health among people with severe mental ill health during the COVID-19 pandemic: Results from a linked UK population cohort study

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