Wichniak Adam, Waliniowska Elzbieta, Wierzbicka Aleksandra, Czasak Krystyna, Musińska Iwona, Szatkowska Eugenia, Jernajczyk Wojciech, Jarema Marek
III Klinika Psychiatryczna IPiN w Warszawie.
Psychiatr Pol. 2009 Mar-Apr;43(2):193-202.
Patients with schizophrenia frequently report disturbed sleep and excessive daytime sleepiness. In this study the sleep quality and daytime sleepiness of patients hospitalized due to psychotic disorders was assessed shortly before the discharge from the hospital.
62 patients treated with antipsychotics (20 F/ 42 M, mean age 25.7 +/- 3.5) were examined. The patients performed a vigilance task (Mackworth clock test), clinical scales were used for the assessment of: sleep quality (Athens insomnia scale - AIS), daytime sleepiness (Epworth sleepiness scale - ESS), clinical global impression (CGI scale), drug side effects (UKU scale), psychopathology and depressive symptoms (PANSS and CDSS scales).
Excessive daytime sleepiness (EDS) was reported in the UKU scale in 58% of the patients. This subjective sensation of EDS was not reflected in the results of the standardized methods for the assessment of EDS. In the ESS scale EDS was found in 20% of the patients. A disturbed vigilance was found in the vigilance task in 32% of the patients.
Subjective feeling of EDS is common in patients treated with antipsychotics. The ESS scale allows to verify the patients' claims. EDS resulting from disturbed or shortened sleep, should be differentiated from sedation resulting from pharmacological treatment and fatigue that may be related to somatic or mental disorders.
精神分裂症患者常报告睡眠障碍和日间过度嗜睡。本研究在因精神障碍住院的患者出院前不久评估其睡眠质量和日间嗜睡情况。
对62例接受抗精神病药物治疗的患者（20例女性/42例男性，平均年龄25.7±3.5岁）进行检查。患者完成一项警觉性任务（麦科沃思时钟测试），使用临床量表评估：睡眠质量（雅典失眠量表 - AIS）、日间嗜睡（爱泼沃斯嗜睡量表 - ESS）、临床总体印象（CGI量表）、药物副作用（UKU量表）、精神病理学和抑郁症状（阳性和阴性症状量表及临床抑郁量表）。
UKU量表显示58%的患者报告有日间过度嗜睡（EDS）。这种EDS的主观感觉未在评估EDS的标准化方法结果中体现。ESS量表显示20%的患者存在EDS。32%的患者在警觉性任务中发现警觉性受损。
接受抗精神病药物治疗的患者中，EDS的主观感觉很常见。ESS量表有助于核实患者的主诉。由睡眠紊乱或缩短导致的EDS应与药物治疗引起的镇静作用以及可能与躯体或精神障碍相关的疲劳相区分。
