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[精神分裂症中的睡眠障碍]

[Sleep disorders in schizophrenia].

作者信息

Staedt J, Hauser M, Gudlowski Y, Stoppe G

机构信息

Klinik für Psychiatrie, Psychotherapie und Psychosomatik-Memory Clinic, Vivantes Klinikum Spandau, Berlin.

出版信息

Fortschr Neurol Psychiatr. 2010 Feb;78(2):70-80. doi: 10.1055/s-0028-1109967. Epub 2010 Jan 11.

Abstract

Difficulties initiating and maintaining sleep as well as circadian rhythm disorders are very common in schizophrenia. Sleeping disorders occur as early signs of the first manifestation of illness as well as early signs of relapse. They bear a relation to positive symptoms and disorganisation of thought. Polysomnographic investigations with schizophrenic patients typically demonstrate a prolonged sleep-onset latency and a decrease in sleep efficiency and slow wave sleep. In particular, distortions of deep sleep can affect neocortical plasticity and cognition negatively. The considerable sleeping disorders are often not sufficiently taken into account in clinical routine. Particularly older antipsychotic medication like Haloperidol can affect the circadian and sleep-wake rhythms negatively. Therefore, pathophysiological changes of sleep within the scope of schizophrenic disorders and their potential implications are discussed in this outline. Regarding therapy, psychoeducative approaches are discussed as well as the administration of antipsychotic medication in accordance with the recommendations of sleep medicine professionals.

摘要

在精神分裂症中,起始和维持睡眠困难以及昼夜节律紊乱非常常见。睡眠障碍既是疾病首次发作的早期迹象,也是复发的早期迹象。它们与阳性症状和思维紊乱有关。对精神分裂症患者进行的多导睡眠图检查通常显示睡眠起始潜伏期延长、睡眠效率降低以及慢波睡眠减少。特别是,深度睡眠的扭曲会对新皮质可塑性和认知产生负面影响。在临床常规中,相当严重的睡眠障碍常常没有得到充分重视。特别是像氟哌啶醇这样的老一代抗精神病药物会对昼夜节律和睡眠-觉醒节律产生负面影响。因此,本概述将讨论精神分裂症范围内睡眠的病理生理变化及其潜在影响。关于治疗,将讨论心理教育方法以及根据睡眠医学专业人员的建议使用抗精神病药物。

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