Psychology Research and Behavior Management (Dec 2022)
The Management of Sleep Disturbances in Patients with Schizophrenia: A Case Series
Abstract
Jakub Vanek,1 Jan Prasko,1– 4 Samuel Genzor,5 Jan Mizera5 1Department of Psychiatry, University Hospital Olomouc, Faculty of Medicine, Palacky University in Olomouc, Olomouc, The Czech Republic; 2Department of Psychological Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic; 3Department of Psychotherapy, Institute for Postgraduate Training in Health Care, Prague, The Czech Republic; 4Rehabilitation Hospital Beroun, Jessenia Inc, Akeso Holding, Závodí, The Czech Republic; 5Department of Respiratory Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, The Czech RepublicCorrespondence: Jan Prasko, Department of Psychiatry, Faculty of Medicine and Dentistry, University Hospital Olomouc, I. P. Pavlova 6, Olomouc, 77900, The Czech Republic, Email [email protected]: Patients with schizophrenia commonly encounter a variety of sleep disorders. Disturbed sleep can be found in 30– 80% of patients, depending on the degree of psychotic symptomatology. Difficulty falling asleep, maintaining, or achieving restful sleep is associated with symptom severity and has been reported as a prodromal symptom of psychotic relapse. Although some sleep disorders improve with antipsychotic treatment, in many cases, even during disease remission, sleep continues to be fragmented, or even different pathophysiological mechanism is causing sleep disruption. Moreover, it may be complicated if the patient needs specific treatment, such as positive airway pressure (PAP) therapy, due to sleep-disordered breathing. The article presents case reports of patients with schizophrenia with sleep disturbances. As presented in our case reports, cognitive behavioral therapy seems effective in treating comorbid insomnia, even in patients with schizophrenia. The second and third case reports emphasise the need for broader clinical considerations, a cross-diagnostic approach, and cooperation in care for patients with severe mental disorders.Keywords: schizophrenia, sleep, REM sleep, NREM sleep, polysomnography, actigraphy, antipsychotics, hypnotics, cognitive behavioral therapy, symptomatology
