Yamashita Hidehisa, Mori Kazuhiko, Nagao Masatsugu, Okamoto Yasumasa, Morinobu Shigeru, Yamawaki Shigeto
Dept. of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Am J Geriatr Psychiatry. 2005 May;13(5):377-84. doi: 10.1176/appi.ajgp.13.5.377.
The authors investigated the influence of aging on the improvement of subjective sleep quality by atypical antipsychotic drugs in patients with schizophrenia.
Subjects were 86 inpatients (mean age: 61.4 years) who had been receiving treatment with conventional antipsychotic drugs and who met DSM-IV criteria for schizophrenia. Their antipsychotic medication was changed from conventional antipsychotics to one of four atypical antipsychotic drugs (olanzapine, perospirone, quetiapine, or risperidone). Patients were grouped by age (older or younger than 65 years). Subjective sleep quality and psychopathology were assessed twice: 1) at baseline, and 2) 8 weeks after switching to the atypical antipsychotic drugs. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), and the Positive and Negative Syndrome Scale (PANSS) was used to measure psychopathology.
The proportion of the patients who experienced improved subjective sleep quality was significantly higher in the elderly than in the middle-aged group. Logistic-regression analysis revealed that the improvement in subjective sleep quality through administration of atypical antipsychotic drugs was predicted by increased age, daytime dysfunction, and longer sleep latency at baseline.
These results demonstrate that atypical antipsychotic drugs are beneficial to the quality of sleep in elderly patients with schizophrenia.
作者研究了衰老对非典型抗精神病药物改善精神分裂症患者主观睡眠质量的影响。
研究对象为86名住院患者（平均年龄：61.4岁），他们一直在接受传统抗精神病药物治疗，且符合精神分裂症的DSM-IV标准。他们的抗精神病药物从传统抗精神病药物换成了四种非典型抗精神病药物之一（奥氮平、哌罗匹隆、喹硫平或利培酮）。患者按年龄分组（65岁及以上或以下）。主观睡眠质量和精神病理学评估进行了两次：1）基线时，2）换用非典型抗精神病药物8周后。使用匹兹堡睡眠质量指数（PSQI）评估主观睡眠质量，并用阳性和阴性症状量表（PANSS）测量精神病理学。
老年患者中主观睡眠质量得到改善的患者比例显著高于中年组。逻辑回归分析显示，年龄增加、日间功能障碍和基线时较长的入睡潜伏期可预测通过使用非典型抗精神病药物改善主观睡眠质量。
这些结果表明，非典型抗精神病药物对老年精神分裂症患者的睡眠质量有益。
