Schizophrenia has two groups of symptoms – positive and negative. It can also have many stages and forms. Insomnia is not a specific symptom of a particular degree of the disease. It can appear almost constantly but in different variations. Some patients simply do not sleep well and often wake up, others may not sleep for days. In the article, we will tell you what connection there is between insomnia and schizophrenia.
General information about schizophrenia
First, let’s look at the main features of the two concepts – “schizophrenia” and “insomnia”. The first is the definition of a psychiatric illness in which there is a breakdown of thinking and emotional reactions. A person with this diagnosis may see hallucinations, consider himself Napoleon, or fall into a catatonic stupor, freezing in an unnatural position for a long time.
However, this is only a superficial view of this pathology. In fact, it is much more difficult. Moreover, the volume of facts on this topic is constantly increasing, because schizophrenia has not been fully studied, and scientists still have a lot to do and discover. So far, they have not been able to identify the exact causes and mechanism of the development of schizophrenia spectrum diseases.
Often they are genetically determined. But, firstly, approximately 10% of patients do not have a genetic predisposition to schizophrenia, and secondly, not all people with “bad” genetics necessarily develop such a pathology. For this reason, it is not yet possible to cure it. The diagnosis is chronic and is made to a person for life, even if he has had only one attack in all the years.
Schizophrenia is characterized by delusional disorders, and split personality is included in the concept of “dissociative identity disorder”.
The symptoms of schizophrenia are divided into two groups – positive and negative. Among the first are delusions, hallucinations, and movement disorders. Such signs indicate the activity of the psyche. Insomnia, if manifested in this phase, is due to excessive excitement. In this state, the patient may not sleep for several days.
Negative symptoms include apathy, lack of will, anhedonia, and lack of initiative. Insomnia can manifest itself in the form of various forms of sleep disturbance. Some people often wake up and suffer from nightmares, others walk around drowsy all day and cannot sleep at night. As a result, they lose their regimen, and the day changes with the night. This greatly affects the physical and emotional state of the patient.
General information about insomnia
Scientists call insomnia, and the science that deals with sleep, somnology. This phenomenon is quite common. It is characterized by insufficient duration or poor quality of sleep (or a combination of these phenomena) for a long period. There can be many reasons for insomnia – from banal stress to severe mental disorder.
In general, there are several forms of manifestation of insomnia:
- Long sleep. A person may even be tired, but at the same time, it takes him several hours to fall asleep. As a rule, such a condition is associated with the presence of acute stress, a specific problem that, according to the person, requires an urgent solution.
- Frequent awakening. It indicates superficial sleep, which can be the result of chronic stress when a person has accumulated many problems.
- Waking up in the middle of the night. Some people fall asleep quickly and sleep well, but sometimes they wake up in the middle of the night and cannot fall asleep until almost morning or for several hours. Often this form of insomnia is observed in people with a high level of responsibility. They can’t let go of daytime tasks and keep replaying them in their head even at night.
- Awakening in the morning. One of the most annoying forms of insomnia is frequent waking hours before the alarm. As a result, a person can no longer fall asleep. He goes to work all broken as if he had not rested. A similar variant of insomnia, as a rule, develops against a background of serious depression.
With schizophrenia, any type of insomnia from those listed is possible. Also, schizophrenics are often tormented by nightmares and dreams of strange, bizarre content. Many of them are out of order. It is almost impossible to work in such a state. It is possible that developed insomnia signals the beginning of a new attack.
In the US, sleep disorders are diagnosed annually in 25 million people.
Next, consider the main aspects of insomnia that occurs with schizophrenia. We will find out if it is a sign of the initial phase of the disease.
Prodrome and insomnia
The prodrome is the initial stage of schizophrenia. It may also be invisible. It’s just that a person begins to actualize certain traits and personality traits. It is not always possible to identify psychopathology by such signs already during this phase. Typical symptoms of the prodromal period are:
- Neurotic manifestations: anxiety, irritation, anger.
- Mood swings for no apparent reason.
- Depressive symptoms: apathy, anhedonia, abulia.
- Physical signs: sleep disturbances, poor appetite.
- Cognitive changes: problems with speech, memory, and attention.
To put it simply, a person begins to change, and not for the better. But not everyone will suspect a mental disorder in such symptoms. In most cases, they are explained by fatigue, stress, or depression, meaning the latter is not a disease, but simply a bad mood.
Sleep in this state is disturbed because there is stress and anxiety. Violations can be different – any of the previously listed forms of insomnia.
Insomnia and antipsychotics
Antipsychotic drugs, which are used in schizophrenia, may have a beneficial effect on sleep. However, approximately 30% of patients experience residual insomnia, which is the result of medication. In addition, antipsychotics can cause akathisia and restless legs syndrome, which also contribute to the development of insomnia.
Akathisia is a syndrome in which a person periodically experiences a feeling of motor restlessness. He needs to constantly move or change his position to calm down. Often this phenomenon is observed after the use of neuroleptics (“typical antipsychotics”).
Restless legs syndrome is similar to akathisia, but in such cases, a person experiences discomfort in the lower extremities. At the same time, it is quite difficult to accurately describe this problem if you yourself have not encountered it. In this state, you want to move your legs, take a twisted fetal position, roll over on your side, put a pillow between your legs, etc. Such symptoms negatively affect the quality of sleep, as they simply interfere with sleep.
One study found that restless leg syndrome was more common in patients with schizophrenia. It is likely that in this case, the cause is antipsychotic drugs.
Apnea in schizophrenia
We usually call apnea snoring. However, the latter is only a consequence of the cessation of pulmonary ventilation for 10 seconds or more. At this time, if the breath is held during sleep, the person snores. The prevalence of sleep apnea in patients with schizophrenia is approximately 15.4%. Moreover, this may be due to various factors, including obesity, which is a side effect of antipsychotic therapy.
In the treatment of residual insomnia, melatonin shows itself well. It increases the duration of sleep and improves its quality. Paliperidone can also be used to help the patient fall asleep faster. Do not self-medicate. The doctor must prescribe the medication to the patient.
Quality sleep in schizophrenia is very important. But if the patient does not do anything for this, then there will be less chance of prolonging the remission. He is encouraged to lead a healthy lifestyle and spend more time outdoors. This regimen helps both healthy and mentally ill people sleep better.