Schizophrenia has two types of symptoms – positive and negative. It can also have many stages and types. Insomnia is not a specific sign of a particular condition. It may appear almost constantly but in different variations. Some patients do not sleep well and often wake up, while others may not sleep for days. This article will show you what the relationship is between insomnia and schizophrenia.


Insomnia in schizophrenia


What schizophrenia is all about

Let us first understand the basic features of the two concepts of “schizophrenia” and “insomnia. The first is the definition of a psychiatric illness in which there is a disintegration of thinking and emotional reactions. A person with this diagnosis may see hallucinations, think of himself as Napoleon, or fall into a catatonic stupor, freezing in an unnatural pose for a long time.

However, this is only a superficial look at this pathology. It is much more complicated. And the volume of facts on this topic is constantly increasing because schizophrenia has not been studied to the end. There is still much for scientists to do and discover. So far, they have not been able to identify the exact causes and mechanism of the development of schizophrenic spectrum disorders.

Often they are genetically conditioned. But firstly, about 10% of patients have no genetic predisposition to schizophrenia, and secondly, not all people with “bad” genetics necessarily develop this pathology. For this reason, it is not yet possible to cure it. The diagnosis is chronic and is made for life, even if a person has had only one attack over the years.

Delusional disorders characterize schizophrenia and split personality in the concept of dissociative identity disorder.

See Also: Wha Is Nightmare Disorder?

The symptoms of schizophrenia are divided into two groups, positive and negative. Among the former are delusions, hallucinations, and movement disorders. Such signs indicate mental activity. Insomnia, if it appears in this phase, is due to excessive excitement. In such a state, the patient may not sleep for several days.

Negative symptoms include apathy, lack of willpower, anhedonia, and lack of initiative. Insomnia can manifest itself in various forms of sleep disturbance. Some people wake up and have nightmares, while others walk around sleepy all day and cannot sleep at night. As a result, their routines become disrupted, and the day alternates with the night. It greatly affects the physical and emotional state of the patient.


What insomnia is all about

Scientists call insomnia the science that deals with sleep somnology. This phenomenon is quite common. It is characterized by insufficient duration or poor sleep quality (or a combination of these phenomena) for a long period. The causes of insomnia can be many – from banal stress to severe mental illness.

In general, we can distinguish several forms of insomnia:

  • Long periods of falling asleep. A person may even be tired, but it takes him several hours to fall asleep. As a rule, this condition is associated with the presence of acute stress, a specific problem that a person believes requires an urgent solution.
  • Frequent awakening. It is a sign of superficial sleep, which can result from chronic stress when a person has accumulated many problems.
  • They wake up in the middle of the night. Some people fall asleep quickly and sleep well, but at the same time, 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 seen in people with a high level of responsibility. They can not let go of the day’s tasks and continue to scroll through them in their heads even at night.
  • He wakes up in the morning. One of the most unpleasant forms of insomnia is frequent awakenings several hours before the alarm clock. As a result, the person never manages to sleep again. He goes to work all broken up as if he has never rested. This type of insomnia usually develops against a background of severe depression.
See Also: Schizophrenia and Bipolar Disorder – What’s the difference?

In schizophrenia, any type of insomnia is possible. People with schizophrenia are also often plagued by nightmares and dreams of strange, bizarre content. Many have trouble with their routines. It is almost impossible to work in such a state. Insomnia that has developed may signal the beginning of a new attack.

Globally, various forms of insomnia affect almost a third of the population. In the US, sleep disorders are diagnosed yearly in 25 million people.

Next, let’s look at the main aspects of insomnia that occurs in schizophrenia. Let’s find out if it is a sign of the initial phase of the disease.


Prodrome and insomnia

Prodrome is the initial stage of schizophrenia. It can also be unnoticeable. The person starts to actualize certain traits and properties of the personality. It is not always possible to identify psychopathology already during this phase by such signs. Typical symptoms of the prodromal period are:

  • Neurotic manifestations: anxiety, irritation, anger.
  • Mood swings for no apparent reason.
  • Depressive signs: apathy, anhedonia, abulia.
  • Physical signs: sleep disorders, poor appetite.
  • Cognitive changes: problems with speech, memory, and attention.

Simply put, a person begins to change, 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, implying that the latter is not a disease but simply a bad mood.

Sleep in such a condition is disturbed because there is stress and anxiety. Disorders can be any of the forms of insomnia listed above.


Insomnia and Antipsychotics

Antipsychotic medications used for schizophrenia can have beneficial effects on sleep. However, approximately 30% of patients experience residual insomnia due to the medication. Additionally, antipsychotics can cause akathisia and restless legs syndrome, contributing to insomnia.

Akathisia is a syndrome in which a person has periodic feelings of movement anxiety. He needs to move or change posture to calm down constantly. This phenomenon is often observed after using neuroleptics (“typical antipsychotics”).

Restless legs syndrome is similar to akathisia, but in such cases, the person experiences uncomfortable sensations in the lower extremities. At the same time, it is difficult to describe this problem if you have not encountered it accurately. In such a condition, you want to move your legs, take a twisted fetal position, turn over on your side, put a pillow between your legs, etc. Such symptoms hurt sleep quality, as they prevent you from falling asleep.

A study found that restless legs syndrome is more common in patients with schizophrenia. It is likely that in this case, too, the antipsychotic medications are the cause.


Apnea in schizophrenia

We usually refer to apnea as snoring. However, the latter is only a consequence of stopping pulmonary ventilation for 10 seconds or more. During this time, the person snores if breath-holding is observed during sleep. The prevalence of apnea in patients with schizophrenia is about 15.4%. And it can be associated with various factors, including obesity, which can be a side effect of antipsychotic therapy.



Melatonin is very good for treating residual insomnia. It increases the duration of sleep and improves its quality. Paliperidone can also be used to help patients fall asleep more quickly. Do not self-medicate. It is up to your doctor to prescribe medication.

Quality sleep in schizophrenia is very important. But if the patient does nothing to do about it, the chances of prolonging remission will be less. He is advised to lead a healthy lifestyle and be out in the fresh air more often. Such a regimen helps both healthy and mentally ill people sleep better.