Effects of polypharmacy on sleep in psychiatric inpatients

The relationship between psychotropic drugs and sleep remains poorly understood. In this study, we examined the relationship between the number (and dosage) of concurrently-taken antipsychotic medications and sleep in a psychiatric inpatient population. Eighty-three long-stay inpatients with severe mental disorders were administered the Pittsburgh Sleep Quality Index questionnaire (PSQI). Results showed that increasing antipsychotics dosages were linked to better sleep, although antipsychotic medications only accounted for a relatively small amount of the variance in sleep quality. The results also showed that, when taken in combination with several antipsychotics, SSRI/SNRI antidepressants failed to show the expected disruptive effects on sleep patterns and daytime functions. Altogether, sleep complaints remained pervasive in 70% of this medicated clinical sample. This suggests that the use of the sedative properties of antipsychotic medication has limited efficacy as a treatment option for sleep dysfunctions, and is not an appropriate substitute for other sleep interventions. Altogether, the results support the case for more systematic screening and interventions for sleep problems in patients with severe psychiatric illness.