Sleep in Untreated Patients With Schizophrenia: A Meta-Analysis

Abstract

The present meta-analysis investigated the characteristics of sleep in patients with schizophrenia without neuroleptic treatment at the time of sleep recording. The 20 selected studies included 652 participants (321 patients with schizophrenia and 331 healthy subjects). Effect sizes were evaluated using d values for the following sleep variables: sleep latency (SL), total sleep time (TST), sleep efficiency index (SEI), total awake time (TAT), stage 2 percentage (S2%), stage 4 percentage, slow-wave-sleep percentage, rapid-eye-movement (REM) percentage, and REM latency. The initial meta-analysis revealed that patients with schizophrenia have the following sleep disorders: increased SL, decreased TST, and decreased SEI. A moderator analysis revealed that these sleep disorders were worse for the neuroleptic-withdrawal group relative to the never-treated group. However, only never-treated patients showed significantly increased TAT and diminished S2%. These results confirm that patients with schizophrenia have sleep disorders that are not necessarily a consequence of neuroleptic treatments, suggesting that sleep disorders are an intrinsic feature of schizophrenia. However, it must be noted that some sleep disorders may be amplified by residual effects of neuroleptic withdrawal, while others appear to be dampened by neuroleptic treatment.

Sleep dysfunctions in schizophrenia: A practical review

“…Clinical observations, subjective reports, and questionnaire studies have been remarkably consistent in showing difficulties falling sleep ("increased sleep latency"), sleep interruptions, and longer need for sleep [4][5][6] in SZ. Indeed, studies suggest that approximately 50% -70% of individuals with SZ experience insomnia [6].…”

“…Actigraphy monitoring, which allows 24 hr online recording of wrist movements from which sleep is inferred, provides evidence that increased sleep latency and difficulties in maintaining sleep are a characteristic feature of the disorder in medicated and unmedicated individuals e.g. [5,7]. The evidence also suggests that reduced sleep duration is more commonly reported in neuroleptic-naive or drug-free individuals, while a longer need for sleep is reported in medicated samples [4,8], consistent with drug studies demonstrating the sedative properties of antipsychotic medication.…”

“…Rapid-eye movement (REM) sleep abnormalities have also been reported, including reduced latency to the onset of the first REM period [15][16][17]. However, negative findings also exist and neither SWS nor REM sleep abnormalities are consistently observed; in addition, neither survive meta-analyses of SZ patients and healthy or psychiatric controls [5,7].…”

Le développement d’une approche clinique pour les troubles du sommeil en pédopsychiatrie

“…Ceci a rapidement donné lieu à un ambitieux projet de recherche sur le sommeil de patients schizophrènes en premier épisode (Chouinard, Poulin, Stip et Godbout, 2004) : dès qu'un patient admissible au projet était inscrit à l'urgence nous étions prévenus et on lui proposait de dormir deux nuits consécutives au laboratoire et de retourner à l'urgence le jour. Une réponse affirmative entraînait une série de démarches dès que le formulaire de consentement était signé : obtenir la confirmation d'Emmanuel Stip qu'il pourrait être présent toute la nuit au laboratoire ou à l'hôpital à titre de médecin de garde pour ce patient, trouver une technicienne de soir pour installer les électrodes sur le patient, trouver un technicien de nuit pour surveiller l'enregistrement et veiller au bien-être du patient.…”

Messenger RNA expression profile of sleep-related genes in peripheral blood cells in patients with chronic kidney disease

“…Recent studies have indicated a relationship between sleep abnormalities, including alterations in REM/non-REM duration, and some psycho-neurological diseases, such as depression [11,12] and schizophrenia [13,14]. Changes in the REM/non-REM duration in CKD patients have also been described.…”