Schizophrenia and Sleep: How Schizophrenia can Disrupt Sleep and Preventive Measures

Overview

A good night’s rest enables an individual to perform the daily tasks effortlessly. However, sleep disruption not only leads to tiredness but also interrupts cognitive functions. This results in learning disability in children, memory impairment in people of all ages, personality changes, and depression. It is also the first sign of schizophrenia. Schizophrenia and Sleep are closely linked. Here is a complete guide to how schizophrenia can disrupt sleep and various preventive measures.

What is a schizophrenia disorder?

Schizophrenia is a mental health condition where a person perceives reality differently. The patients may experience hallucinations, delusions, and disorganized thoughts that affect their daily life. The disorder first manifests during the early twenties, but it can exhibit signs at any time of life.

Disruption of the sleep pattern is one of the early symptoms of schizophrenia. The patient may not be able to sleep for the entire night or only sleeps for a couple of hours. Managing sleep disruptions is essential in managing schizophrenia.

What are the common types of sleep disturbances associated with schizophrenia?

Research has shown that 20 to 30 percent of schizophrenic people experience sleep disturbance. There are different kinds of sleep disorders and not everyone experiences them. Here is a rundown of various sleep disturbances:

Insomnia

Insomnia is a condition where the person finds it difficult to fall or stay asleep. Unlike others, they may experience around three sleepless nights a week. This condition can occur due to several causes. But in schizophrenic patients, it happens due to variation in the dopamine levels.

Dopamine is a chemical produced by the brain cells to send signals between nerves. An optimum level of dopamine helps in the better functioning of the human body. If the dopamine level is high, the sleep hormone melatonin’s level lowers, and a message is sent to the brain to wake up. It is difficult for people with schizophrenia to manage insomnia since both are affected by dopamine levels. Both sleep deprivation and schizophrenia are interlinked to each other.

Circadian rhythm disorders

Let us first understand the meaning of circadian rhythm. It is a person’s sleep-wake pattern during the 24-hours. It controls the daily sleep and wakefulness schedule and is influenced by light and dark, along with other factors. If this rhythm gets disrupted, it may lead to circadian rhythm disorder.

In this condition, either the person sleeps too much or too little. It will also be difficult to maintain a daily sleep routine. People with schizophrenia are most likely to get circadian rhythm disorder as an early indicator of schizophrenia, a symptom that can appear even before hallucinations or delusions.

Narcolepsy

Narcolepsy is a neurological disorder that affects the control of sleep and wakefulness. Narcolepsy patients experience severe daytime sleepiness and sudden, uncontrollable episodes of falling asleep while performing daily tasks and at any time of the day. Some patients experience sudden muscle weakness with laughter and other emotions.

Restless Leg Syndrome and Periodic Limb Movement disorder

Restless leg syndrome (RLS) is a condition where one gets an uncontrollable urge to move one’s legs. This can increase during evenings while lying down and can disrupt sleep. Whereas, a periodic limb movement disorder (PLMD) is the cramping or jerking of the legs while asleep. This condition can often occur along with RLS or other sleep disorders. It is also possible that it occurs on its own.

Obstructive sleep apnea

Obstructive sleep apnea (OSA) is a condition that is caused by blocked airways while one sleeps. Snoring, dry mouth, poor sleep, and fatigue can be the symptoms of sleep apnea. Researchers suggest that sleep apnea is the most common condition found in schizophrenic patients. The medications taken for schizophrenia can sometimes cause obesity and may lead to OSA.

Schizophrenia and Sleep: What are the causes of sleep disorders with schizophrenia?

Some of the causes of sleep disorders can be:

• Poor sleeping environment
• Lack of physical activity during daytime
• Erratic circadian rhythm
• Fear of sleeplessness which again causes sleepless nights
• Paranoia from a traumatic past experience

Also Read About: Post Traumatic Stress Disorder

When should you contact the doctor?

When the sleeping disorder becomes complicated enough to affect the personal and professional life of a person, the doctor should be contacted for appropriate treatment.

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Schizophrenia and Sleep: What are the risks of sleep disruption?

Sleep is a biological process that restores and refreshes the mental and physical health of a person. Lack of proper sleep can cause several issues including disorganised thoughts, impaired memory power, lack of concentration, anger, frustration, hallucinations, delusions, and others. Sleep disorder negatively affects the treatment methodologies planned for the patient or sometimes causes a relapse. Lack of sleep can also cause physical complications like obesity, high blood pressure, weak immune system, diabetes, and other health issues.

How to diagnose Sleep disorders with Schizophrenia?

The health care provider may use different techniques to diagnose sleep disorders. They may ask questions related to sleep patterns or make one fill out specially prepared questionnaires. Sometimes one will be asked to keep a sleep tracker (a device or mechanical tracking) to record the sleep pattern. The sleep pattern of the patient can also be observed in a lab environment. These methods give the healthcare provider an idea of how one sleeps and the disruptions one faces.

What are the treatment options to handle sleep disorders with schizophrenia?

The treatment options may be chosen based on the kind of sleep disorder. It may vary from one person to another.

• Cognitive-behavioural therapy: This is a common method used to treat sleep disorders with schizophrenia. This method provides tools to handle stress which causes disordered sleeping patterns. It is more effective since it helps the physician to understand and treat the underlying cause behind the sleep disorder.
• Medications: The antipsychotic medications that are used to treat schizophrenia can induce sleep. The doctor may adjust the dosage to fit each patient’s requirement.
• Non-stimulant sleeping medications: There are meds exclusively to help one sleep. The health care provider will check whether these pills can be taken along with the medications for schizophrenia and may prescribe accordingly. This option is less chosen to reduce the patient’s dependence on the pills to sleep. But there are cases where this works better than other treatment options.
• Balance diet and exercise: The right diet and regular exercise may also be suggested to help the person sleep better.

Schizophrenia and Sleep: Are there measures to prevent sleep disorders in schizophrenic patients?

There are no preventive measures as far as schizophrenia is concerned. But the following tips may improve the sleeping pattern of a person.

• It is advisable to reduce the temperature of the bedroom and ensure that the patient is comfortable before going to sleep. Dark curtains and earplugs can be used to reduce excessive light and noise.
• It is better to avoid using mobile phones an hour before sleeping. Use that time to journal, or plan the next day’s activities.
• Try setting a particular time to go to bed. Even if it is difficult to sleep at that time, it will help the body slowly adapt to the schedule.
• Avoid sleeping during the daytime. If one is too tired, take a nap and ensure it is less than 30 min.
• Avoid caffeinated drinks after lunch and stay hydrated.

Conclusion

People with schizophrenia are prone to multiple sleep disorders. Lack of proper sleep intensifies schizophrenia and it becomes difficult to manage. The treatments for schizophrenia can be effective only if sleep disorders are under control. It is imperative to meet a health care provider to tackle this.

Frequently Asked Questions

How much sleep is required for an adult?

Experts recommend at least seven to nine hours of sleep for an adult every night. However, some individuals need more sleep and some need less.

What is the time duration for a sleep disorder?

The duration of a sleep disorder varies as it is dependent on the type of sleep disorder the patient is suffering from. The patient must discuss with the health care provider, taking treatments into consideration.

What is circadian rhythm?

Circadian rhythm is the body’s natural clock that helps set the sleeping and waking hours of the body every day.