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Sleep quality in schizophrenia and the effects of atypical antipsychotic medication

Published online by Cambridge University Press:  24 June 2014

P. M. Judith Haffmans ,
Hans J. Oolders ,
Erik Hoencamp  and
Andreas Schreiner
P. M. Judith Haffmans*
Affiliation:
Department of Research, Parnassia, Den Haag, the Netherlands
Hans J. Oolders
Affiliation:
Department of Research, Parnassia, Den Haag, the Netherlands
Erik Hoencamp
Affiliation:
Department of Research, Parnassia, Den Haag, the Netherlands
Andreas Schreiner
Affiliation:
Department of Medical and Scientific Affairs, Janssen-Cilag, Neuss, Germany
*
P. M. J. Haffmans, Department of Research, Parnassia Psycho-Medical Center, Monsterseweg 83, NL-2558 RJ, Den Haag, the Netherlands. Tel: +31 70 391 6582; Fax: +31 70 391 6146; E-mail: [email protected]
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Abstract

Background:

Sleep disorders are widespread among patients with schizophrenia and contribute to adverse clinical outcomes. Antipsychotic drugs exert varying effects on sleep, and the effects of atypical agents may differ from those of conventional neuroleptics.

Objective:

To review the literature on the effects of atypical medication on subjective and objective sleep quality in patients with schizophrenia.

Methods:

A non-systematic literature review of Medline was performed in August 2003 searching the period from January 1985 to August 2003 for studies of the effects of atypical antipsychotics on sleep.

Results:

We found published studies of clozapine, olanzapine, and risperidone, but none on quetiapine or ziprasidone. Studies with clozapine showed that it increased total sleep time, sleep efficiency, stage-2 non-rapid eye movement sleep and rapid eye movement (REM) sleep density, and decreased stage-4 sleep, slow wave sleep (SWS) and stage-1 sleep. Single-dose studies with olanzapine have shown that it increases SWS, sleep continuity, total sleeping time, subjective sleep quality, and delta sleep. Long-term studies with risperidone have shown improvements in total sleep, sleep efficiency, sleep continuity, SWS, and stage-2 sleep, and reductions in sleep latency, number of awakenings, and proportion of time awake. These benefits were paralleled by improvements in subjective sleep assessment and psychopathology, and psychosocial functioning.

Conclusions:

The evidence presented in this review suggests that atypical antipsychotics exert favorable effects on sleep profile compared with conventional agents, including improvement of subjective sleep quality and modification of specific sleep stages known to be associated with better clinical outcome.

Keywords

atypical antipsychoticsclozapineolanzapinerisperidoneschizophreniasleep disorders
Type
Original Article
Information
Acta Neuropsychiatrica , Volume 16 , Issue 6 , December 2004 , pp. 281 - 289
Copyright
Copyright © 2004 Blackwell Munksgaard

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