In the clinic of Professor V.L. For a minute, many mental illnesses are being treated in Moscow, including schizophrenia and accompanying sleep disorders in some cases.
In schizophrenia, various sleep disorders are observed, these are:
· Defects in the continuity of sleep;
Falling asleep disorder;
• dysregulation of the REM phase (reduction in the proportion of REM sleep, decrease in the period of REM latency);
· Reduction of the fourth phase of sleep;
· Lack of information processing during sleep.
There are also variable and invariant sleep parameters in schizophrenia. Variable sleep parameters are REM sleep parameters (REM density and REM latency). They depend on the mental status of the patient, worsening before the exacerbation of psychosis, during psychosis. Sleep invariant parameters are the fourth sleep phase (percentage and duration of slow wave sleep). These parameters do not depend on the phase of the disease (prodromal, exacerbation, stabilization, remission). They are found in all patients with schizophrenia.
According to M. Keshavan with colleagues . (1996), impaired slow wave sleep in humans may be a marker of the risk of developing schizophrenia.
With an increase in the negative symptoms of schizophrenia in young patients, the proportion of “deep sleep” also decreases ( Ganguli R. et al ., 1987).
In patients with schizophrenia, during the period of exacerbation of the disease, there is a disruption in the continuity of sleep, which is measured by the following indicators:
• sleep latency;
· Time of awakening;
· Sleep efficiency;
· Frequency of awakening during sleep;
· Total sleep time;
· Frequency of awakening during the night.
Sleep of schizophrenic patients and healthy people is affected by the state of the dopaminergic system; sleep disturbance indicates its activation, which is characteristic during a psychotic episode and hallucinatory symptoms. At the same time, such indicators as REM latency decrease and decrease in REM sleep density ( Hoyt B., 2005, Feinberg I. et al ., 1965).
In patients with schizophrenia, the processing of information during sleep is also impaired. If light and sound stimuli are sent during sleep to patients with schizophrenia during the night, an increase in theta waves can be detected ( Roschke J. et al ., 1998).
To normalize sleep, patients use clonazepine and other antipsychotics, or hypnotics, tranquilizers.
Scientists have found that even after withdrawal of antipsychotics, sleep changes continue for six weeks ( Neylan T. et al . 1992).
Many researchers associate the study of somnology in patients with schizophrenia with the use of neuroimaging methods . This approach is the most productive and optimal, as it allows you to determine the organic cause of schizophrenia and sleep disorders in this disease.