Sleep quality in schizophrenia and the effects of atypical antipsychotic medication

Background:Sleep disorders are widespread among patients with schizophrenia and contribute to adverse clinical outcomes. Antipsychotic drugs exert varying effects on sleep, and the effects of atypical agents may differ from those of conventional neuroleptics.Objective:To review the literature on the effects of atypical medication on subjective and objective sleep quality in patients with schizophrenia.Methods:A non-systematic literature review of Medline was performed in August 2003 searching the period from January 1985 to August 2003 for studies of the effects of atypical antipsychotics on sleep.Results:We found published studies of clozapine, olanzapine, and risperidone, but none on quetiapine or ziprasidone. Studies with clozapine showed that it increased total sleep time, sleep efficiency, stage-2 non-rapid eye movement sleep and rapid eye movement (REM) sleep density, and decreased stage-4 sleep, slow wave sleep (SWS) and stage-1 sleep. Single-dose studies with olanzapine have shown that it increases SWS, sleep continuity, total sleeping time, subjective sleep quality, and delta sleep. Long-term studies with risperidone have shown improvements in total sleep, sleep efficiency, sleep continuity, SWS, and stage-2 sleep, and reductions in sleep latency, number of awakenings, and proportion of time awake. These benefits were paralleled by improvements in subjective sleep assessment and psychopathology, and psychosocial functioning.Conclusions:The evidence presented in this review suggests that atypical antipsychotics exert favorable effects on sleep profile compared with conventional agents, including improvement of subjective sleep quality and modification of specific sleep stages known to be associated with better clinical outcome.

Download Full-text

Rapid Eye Movement Sleep, Sleep Continuity and Slow Wave Sleep as Predictors of Cognition, Mood, and Subjective Sleep Quality in Healthy Men and Women, Aged 20–84 Years

Frontiers in Psychiatry ◽

10.3389/fpsyt.2018.00255 ◽

2018 ◽

Vol 9 ◽

Cited By ~ 27

Author(s):

Ciro della Monica ◽

Sigurd Johnsen ◽

Giuseppe Atzori ◽

John A. Groeger ◽

Derk-Jan Dijk

Keyword(s):

Sleep Quality ◽

Eye Movement ◽

Slow Wave ◽

Slow Wave Sleep ◽

Rapid Eye Movement ◽

Rapid Eye Movement Sleep ◽

Subjective Sleep Quality ◽

Men And Women ◽

Healthy Men ◽

Subjective Sleep

Download Full-text

Physical Activity and Inhibitory Control: The Mediating Role of Sleep Quality and Sleep Efficiency

Brain Sciences ◽

10.3390/brainsci11050664 ◽

2021 ◽

Vol 11 (5) ◽

pp. 664

Author(s):

Lin Li ◽

Qian Yu ◽

Wenrui Zhao ◽

Fabian Herold ◽

Boris Cheval ◽

...

Keyword(s):

Physical Activity ◽

Sleep Quality ◽

Inhibitory Control ◽

Sleep Efficiency ◽

Equation Modeling ◽

Control Performance ◽

Subjective Sleep Quality ◽

Subjective Sleep ◽

Sleep Parameters ◽

The Relationship

Objectives: the current study aimed to investigate the relationship between physical activity (PA) level and inhibitory control performance and then to determine whether this association was mediated by multiple sleep parameters (i.e., subjective sleep quality, sleep duration, sleep efficiency, and sleep disturbance). Methods: 180 healthy university students (age: 20.15 ± 1.92 years) from the East China Normal University were recruited for the present study. PA level, sleep parameters, and inhibitory control performance were assessed using the International Physical Activity Questionnaire (IPAQ), the Pittsburgh Sleep Quality Index Scale (PSQI), and a Stroop test, respectively. The data were analyzed using structural equation modeling. Results: A higher level of PA was linked to better cognitive performance. Furthermore, higher subjective sleep quality and sleep efficiency were associated with better inhibitory control performance. The mediation analysis revealed that subjective sleep quality and sleep efficiency mediated the relationship between PA level and inhibitory control performance. Conclusion: our results are in accordance with the literature and buttress the idea that a healthy lifestyle that involves a relatively high level of regular PA and adequate sleep patterns is beneficial for cognition (e.g., inhibitory control performance). Furthermore, our study adds to the literature that sleep quality and sleep efficiency mediates the relationship between PA and inhibitory control performance, expanding our knowledge in the field of exercise cognition.

Download Full-text

0337 Effects of Slow Wave Sleep Augmentation on Subjective Sleep Quality

SLEEP ◽

10.1093/sleep/zsy061.336 ◽

2018 ◽

Vol 41 (suppl_1) ◽

pp. A129-A129

Author(s):

M L Lamphere ◽

C S Robinson ◽

N B Bryant ◽

A P Jones ◽

B Robert ◽

...

Keyword(s):

Sleep Quality ◽

Slow Wave ◽

Slow Wave Sleep ◽

Subjective Sleep Quality ◽

Subjective Sleep

Download Full-text

Effects of exercise on sleep

Journal of Applied Physiology ◽

10.1152/jappl.1978.44.6.945 ◽

1978 ◽

Vol 44 (6) ◽

pp. 945-951 ◽

Cited By ~ 53

Author(s):

J. M. Walker ◽

T. C. Floyd ◽

G. Fein ◽

C. Cavness ◽

R. Lualhati ◽

...

Keyword(s):

Eye Movement ◽

Slow Wave Sleep ◽

Nrem Sleep ◽

Sleep Stages ◽

Absolute Amount ◽

Rapid Eye Movement ◽

Personality Profiles ◽

Experimental Conditions ◽

Strong Trend ◽

Delta Activity

We tested the hypothesis that EEG sleep stages 3 and 4 (slow-wave sleep, SWS) would be increased as a function of either acute of chronic exercise. Ten distance runners were matched with 10 nonrunners, and their sleep was recorded under both habitual (runners running and nonrunners not running, 3 night) and abruptly changed (runners not running and nonrunners running, 1 night) conditions. Analyses of both visually scored SWS and computer measures of delta activity during non-rapid eye-movement (NREM) sleep failed to support the SWS-exercise hypothesis. The runners showed a significantly higher proportion and a greater absolute amount of NREM sleep than the nonrunners. The runners showed less rapid eye-movement activity during sleep than the nonrunners under both experimental conditions, indicating a strong and unexpected effect of physical fitness on this measure. Modest afternoon exercise in nonrunners was associated with a strong trend toward elevated heart rate during sleep. Mood tests and personality profiles revealed few differences, either between groups or within groups, as a function of exercise.

Download Full-text

Remifentanil Inhibits Rapid Eye Movement Sleep but Not the Nocturnal Melatonin Surge in Humans

Anesthesiology ◽

10.1097/aln.0b013e3181684bc3 ◽

2008 ◽

Vol 108 (4) ◽

pp. 627-633 ◽

Cited By ~ 23

Author(s):

Christopher P. Bonafide ◽

Natalie Aucutt-Walter ◽

Nicole Divittore ◽

Tonya King ◽

Edward O. Bixler ◽

...

Keyword(s):

Plasma Concentration ◽

Sleep Disturbance ◽

Eye Movement ◽

Repeated Measures ◽

Slow Wave Sleep ◽

Constant Infusion ◽

Sleep Stages ◽

Rapid Eye Movement ◽

Rapid Eye Movement Sleep ◽

Placebo Capsule

Background Postoperative patients are sleep deprived. Opioids, commonly administered for postoperative pain control, are often mistakenly considered inducers of naturally occurring sleep. This study describes the effect of the opioid remifentanil on nocturnal sleep in healthy volunteers. In addition, this study tests the hypothesis that opioid-induced sleep disturbance is caused by a circadian pacemaker disturbance, reflected by suppressed nocturnal plasma concentration of melatonin. Methods Polysomnography was performed in 10 volunteers from 11:00 pm to 7:00 am for four nights at 6-day intervals. On two nights, remifentanil (0.01-0.04 microg x kg x min) was infused from 10:30 pm to 7:00 am, and either a placebo capsule or 3.0 mg melatonin was administered at 10:30 pm. On two additional nights, saline was infused, and the placebo or melatonin capsules were administered at 10:30 pm. Blood was drawn at 12:00 am, 3:00 am, and 6:00 am to measure the plasma concentration of melatonin and cortisol. A repeated-measures analysis of variance model was used to determine the effect of remifentanil on sleep stages, the effect of remifentanil on the plasma concentration of melatonin, and the effect of exogenous melatonin on remifentanil-induced sleep disturbance. Results Remifentanil inhibited rapid eye movement sleep (14.1 +/- 7.2% to 3.9 +/- 6.9%). The amount of slow wave sleep decreased from 6.8 +/- 7.6% to 3.2 +/- 6.1%, but this decrease was not statistically significant. Remifentanil did not decrease melatonin concentration. Melatonin administration did not prevent remifentanil-induced sleep disturbance. Conclusions An overnight constant infusion of remifentanil inhibits rapid eye movement sleep without suppressing the nocturnal melatonin surge.

Download Full-text

Sleep continuity, stability and organization in good and bad sleepers

Journal of Health Psychology ◽

10.1177/1359105320903098 ◽

2020 ◽

pp. 135910532090309 ◽

Cited By ~ 3

Author(s):

Francesca Conte ◽

Mariangela Cerasuolo ◽

Giuseppina Fusco ◽

Fiorenza Giganti ◽

Iginio Inserra ◽

...

Keyword(s):

Sleep Quality ◽

Frequency Stability ◽

State Transitions ◽

Subjective Sleep Quality ◽

Quality Perception ◽

Subjective Sleep ◽

Sleep Continuity ◽

Sleep Parameters ◽

Sleep Recording ◽

The Relationship

The relationship between objective and subjective sleep quality is still debated. Here, we investigate differences in objective sleep parameters in habitual subjective good sleepers and bad sleepers with the aim of evaluating sleep continuity, stability and organization as possible determinants of subjective sleep quality. In total, 38 subjects (good sleepers, N = 18; bad sleepers, N = 20) underwent two nights of sleep recording. Traditional sleep parameters displayed no between-groups differences. Conversely, bad sleepers showed lower sleep continuity (awakenings frequency), stability (e.g. arousals and state transitions frequency) and organization (e.g. number of sleep cycles and time spent in cycles). Our findings point to the involvement of these measures in determining habitual sleep quality perception and suggest the possibility to include them in standard sleep assessments.

Download Full-text

The Benefits of Closed-Loop Transcranial Alternating Current Stimulation on Subjective Sleep Quality

Brain Sciences ◽

10.3390/brainsci8120204 ◽

2018 ◽

Vol 8 (12) ◽

pp. 204 ◽

Cited By ~ 6

Author(s):

Charles Robinson ◽

Natalie Bryant ◽

Joshua Maxwell ◽

Aaron Jones ◽

Bradley Robert ◽

...

Keyword(s):

Sleep Quality ◽

Slow Wave ◽

Closed Loop ◽

Slow Wave Sleep ◽

The United States ◽

Alternating Current ◽

Poor Sleep ◽

Subjective Sleep Quality ◽

Subjective Sleep ◽

Transcranial Alternating Current Stimulation

Background: Poor sleep quality is a common complaint, affecting over one third of people in the United States. While sleep quality is thought to be related to slow-wave sleep (SWS), there has been little investigation to address whether modulating slow-wave oscillations (SWOs) that characterize SWS could impact sleep quality. Here we examined whether closed-loop transcranial alternating current stimulation (CL-tACS) applied during sleep impacts sleep quality and efficiency. Methods: CL-tACS was used in 21 participants delivered at the same frequency and in phase with endogenous SWOs during sleep. Sleep quality was assessed in the morning following either verum or sham control stimulation during sleep, with order counterbalanced within participants. Results: Higher sleep quality and efficiency were found after verum stimulation nights compared to control. The largest effects on sleep quality were found immediately following an adaptation night in the laboratory for which sleep quality was reduced. Conclusions: Applying CL-tACS at the same frequency and phase as endogenous SWOs may offer a novel method to improve subjective sleep quality after a night with poor quality sleep. CL-tACS might be helpful for increasing sleep quality and efficiency in otherwise healthy people, and in patients with clinical disorders that involve sleep deficits.

Download Full-text

0679 Effects Of Cannabimimetic Enhancement On Subjective Sleep Quality And Function In Obstructive Sleep Apnea

SLEEP ◽

10.1093/sleep/zsaa056.675 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A259-A259

Author(s):

G - Yin ◽

K Reid ◽

D Carley ◽

B Prasad ◽

P Zee

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sleep Quality ◽

Sleep Efficiency ◽

Dependent Manner ◽

Subjective Sleep Quality ◽

Subjective Sleep ◽

Obstructive Sleep ◽

Significant Difference ◽

Daytime Function

Abstract Introduction We previously reported that dronabinol a tetrahydrocannobinol, reduced the apnea hypopnea index (AHI) in patients with obstructive sleep apnea (OSA) in a dose-dependent manner. The aim of this report is to assess the effects of dronabinol on subjective sleep quality and daytime function in the Pharmacotherapy of Apnea by Cannabimimetic Enhancement (PACE) II trial. Methods By random assignment, 73 adults with moderate or severe OSA received either placebo (N = 25), 2.5 mg dronabinol (N = 21), or 10 mg dronabinol (N = 27) daily, 1 hour before bedtime for 6 weeks. Participants completed the Pittsburgh sleep quality index (PSQI) and Functional Outcomes of Sleep Questionnaire (FOSQ-10) at baseline and at the end of intervention. Results Between group comparisons were performed using a one-way ANOVA. At baseline, there were no significant difference between groups in the PSQI or FOSQ-10. When compared to placebo, the 10 mg group had a significant reduction in the global PSQI score (p=0.039). Paired t-test analysis showed, in comparison to the baseline, the subscale and total score of the FOSQ-10 were significantly increased (P=0.005); the global PSQI score, subjective sleep quality score, habitual sleep efficiency score and daytime dysfunction score were significantly reduced (p<0.001, p<0.001, p=0.024, p=0.007 respectively) in the 10 mg group, while no improvement was found in the 2.5 mg or placebo groups. Bivariate correlational analysis was used to identify the relationship between the changes of variables. Both ∆ global PSQI and ∆ total FOSQ were correlated with ∆ESS, but not with change in AHI or sleep parameters such as sleep stage percentage, sleep efficiency, arousal index, minutes of wake after sleep onset, time and duration of oxygen saturation below 90% percent. Conclusion These findings indicate that in addition to its ability to reduce the AHI, dronabinol can improve subjective sleep quality and daytime function in patients with moderate to severe OSA. Support This study was funded by National Institutes of Health, National Heart Lung and Blood Institute Grant Number UM1-HL112856 and National Center for Advancing Translational Sciences, Grant Numbers UL1TR001422 and UL1TR002003.

Download Full-text

P008 A systematic review and meta-analysis of inflammatory bowel disease activity and sleep quality

SLEEP Advances ◽

10.1093/sleepadvances/zpab014.057 ◽

2021 ◽

Vol 2 (Supplement_1) ◽

pp. A24-A24

Author(s):

A Barnes ◽

P Spizzo ◽

R Mountifield ◽

P Bampton ◽

J Andrews ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Sleep Quality ◽

Bowel Disease ◽

Sleep Onset ◽

Sleep Efficiency ◽

Poor Sleep ◽

Subjective Sleep Quality ◽

Subjective Sleep ◽

Inflammatory Bowel ◽

Meta Analyses

Abstract Background Poor sleep quality has been associated with active inflammatory bowel disease (IBD) in several studies. This review examines sleep quality in people with active IBD and in those in remission, with meta-analyses performed, considering subjective and objective sleep quality and IBD activity. Methods Electronic databases were searched from inception to December 1st 2020. A random effects model was used with separate meta-analyses performed for objective and subjective sleep and IBD activity, considering sleep quality in active and inactive IBD. Results 19 studies were included in the qualitative review representing 4972 IBD patients. Subjective IBD activity (11 studies) was associated with subjective sleep quality with pooled odds ratio (OR) for subjective poor sleep in active IBD compared to remission of 3.04 (95% CI 2.41–3.83). Including only studies with objective sleep measures (5 studies), sleep efficiency was lower in those self-reporting active IBD and time awake post sleep onset was higher in those with active IBD. Objective IBD activity was associated with subjective poor sleep (4 studies), with pooled OR of 6.64 95% CI (3.02 – 14.59). Insufficient data was available to consider objective IBD activity and objective sleep quality. Conclusion IBD activity is associated with poor sleep using subjective and objective measures of sleep quality. This poor sleep manifests as decreased sleep efficiency and increased number of waking episodes post sleep onset. The relationship between objective IBD activity and sleep requires further investigation.

Download Full-text