[Sleep and circadian rhythm disturbances in schizophrenia]

In this study we investigated sleep and circadian rhythm, functioning and psychopathological symptoms in patients with schizophrenia. We looked for answers to the following questions: What percentage of patients with schizophrenia after a therapeutic process in the daily psychiatric ward suffers from insomnia and excessive daytime sleepiness? What factors influence the functioning of patients with schizophrenia.

23 patients and 23 healthy controls matched for age and sex (14 women, 9 men; mean age 40.5 +/- 13.66) were examined. All subjects filled out sleep diaries, underwent actigraphy for 7 days, and ratings with scales for the assessment of sleep quality, daytime sleepiness, general clinical state and the degree of improvement, presence and severity of psychopathological symptoms and depression, drug side effects.

Moderate insomnia was found in 6 (26%), severe insomnia in 2 (8%) patients. Four patients (17%) suffered from severe daytime sleepiness. Actigraphy showed a low activity level that had influence on the functioning of patients. The functioning of the patients was most negatively influenced by negative symptoms of schizophrenia and drug side effects. Older patients and those who were ill for a longer time presented more drug side effects and they were more depressive. The patients spent more time in bed and had longer sleep time than healthy controls. The patients presented highest activity at the time of therapeutic activities.

Despite improvement of psychopathological symptoms, many patients with schizophrenia still present low daytime activity and clinically significant insomnia and/or daytime sleepiness, which deteriorates their functioning.