Schlafstörungen bei schizophrenen Erkrankungen

Abstract

Difficulties initiating and maintaining sleep as well as circadian rhythm disorders are very common in schizophrenia. Sleeping disorders occur as early signs of the first manifestation of illness as well as early signs of relapse. They bear a relation to positive symptoms and disorganisation of thought. Polysomnographic investigations with schizophrenic patients typically demonstrate a prolonged sleep-onset latency and a decrease in sleep efficiency and slow wave sleep. In particular, distortions of deep sleep can affect neocortical plasticity and cognition negatively. The considerable sleeping disorders are often not sufficiently taken into account in clinical routine. Particularly older antipsychotic medication like Haloperidol can affect the circadian and sleep-wake rhythms negatively. Therefore, pathophysiological changes of sleep within the scope of schizophrenic disorders and their potential implications are discussed in this outline. Regarding therapy, psychoeducative approaches are discussed as well as the administration of antipsychotic medication in accordance with the recommendations of sleep medicine professionals.

Schlafstörungen und Suizidalität: Zusammenhänge und klinische Bedeutung

“…Mitursächlich scheint hier eine Desynchronisation der zirkadianen Rhythmik mit gestörtem Melatoninstoffwechsel zu sein [80]. Polysomnografisch werden verlängerte Einschlaflatenz, verminderte Schlafeffizienz sowie Veränderungen im REM-und Non-REM-Schlaf dokumentiert [81]. Insbesondere die Erhöhung der REM-Aktivität und REM-Schlaf-Zeit wurde bei psychotischen Patienten unterschiedlicher Diagnosegruppen [82] mit suizidalem Verhalten in Verbindung gebracht [82,83], wobei entsprechende Untersuchungen schizophrener Patientenkollektive ausstehen.…”