Sleep onset REM periods in schizophrenic patients

Abstract

Sleep EEG studies in depression have consistently shown shortened rapid-eye-movement (REM) iatem;y in m~y patients (Kupfer et al 1986), with a smaller subset expe~encing sleeponset REM (SOREM), defined as the onset of REM within 10-20 rain of the onset of sleep. In depression, SOREMs have been associated with greater illness severity (

Sleep in Schizophrenia: Impairments, Correlates, and Treatment

“…Cognitive dysfunction, or thought disorder, is considered the core element of schizophrenia; it too correlates with SWS deficits, perhaps indicative of frontal lobe dysfunction [38]. Additionally, SWS deficits [39] and short REML [23,40] are linked to poor clinical and psychosocial outcome. Finally, three studies demonstrate sleep-related cognitive impairment in schizophrenics relative to healthy controls.…”

“…Positive symptoms also are associated with EEG high frequency activity during the sleep of schizophrenics [33]. Negative symptoms, another aspect of global severity, are associated with short REML [21,23] and SWS deficits [19,[34][35][36][37]. Cognitive dysfunction, or thought disorder, is considered the core element of schizophrenia; it too correlates with SWS deficits, perhaps indicative of frontal lobe dysfunction [38].…”

“…Many studies have examined this issue [13,14,16,[18][19][20][21][22][23][24], and the majority report significantly shorter REMLs in schizophrenics relative to healthy controls. Heterogeneity between patient samples and methodologic differences, including prior exposure to AP treatment, may explain the lack of consistency among these findings.…”

A Patient with Intractable Attacks of Cataplexy

“…Narcolepsy and depression both result in alterations to REM sleep; cataplexy and depression both respond to antidepressant medications; and cataplexy has features resembling catatonia/psychomotor retardation. 7 In our patient, the presence of a SOREMP in the MSLT may be secondary to sleep deprivation, mood disorder, medication withdrawal, schizophrenia, 8 or narcolepsy. The International Classifications of Sleep Disorders precludes the diagnosis of narcolepsy in those with psychiatric conditions, or those on medications that may lead to excessive daytime sleepiness.…”

Sleep Disturbance in Psychiatric Disorders: Effects on Function and Quality of Life in Mood Disorders, Alcoholism, and Schizophrenia

“…The so-called "positive symptoms" of schizophrenia (delusions, hallucinations, disorganized thinking and behavior) have been reported to be correlated with short REM latency, increased REM density, reduced sleep efficiency (time asleep divided by time in bed) and increased sleep latency (87,88,96,(102)(103)(104)(105)(106). The negative symptoms of this disorder, such as impairment in work and relationships and cognitive impairment, have been associated with slow-wave sleep deficits (85,94,95,106,107) and short REM latency (96,108,109). One study links the slow-wave sleep deficit to the enlarged cerebral ventricular size that is a frequent structural MRI finding suggestive of loss of brain tissue in schizophrenia (85).…”