Psychiatric Hospital Center of Lisbon, Lisbon, Portugal.
Int J Psychiatry Clin Pract. 2011 Nov;15(4):311-5. doi: 10.3109/13651501.2011.605954. Epub 2011 Aug 28.
The aim of this study was to compare the endogenous melatonin sleep-promoting effect in schizophrenic patients to a sample of healthy controls.
Thirty-four schizophrenia outpatients (SP) and 34 healthy subjects (HS) participated in this study. Wrist-actigraphy recordings and a sleep diary were used for sleep-wake cycle assessment. The quality and patterns of sleep were measured with the Pittsburgh Sleep Quality Index (PSQI) and the Positive and Negative Syndrome Scale (PANSS) was used for psychopathology assessment. To quantify and assess nocturnal melatonin profiles, saliva samples were collected for one night under dim light conditions (<50 lux) hourly from 20:00 h to 23:00 h.
Scores on PSQI were significantly higher in SP as compared to HS, indicating a worse quality of sleep. Patients sleep more at night, but have poorer sleep efficiency, than HS. Sleep latency and nighttime awakenings were significant higher in SP. Melatonin levels were negatively correlated with sleep latency, total sleep time and positively correlated with sleep efficiency in HS but not in SP.
The results of the present study indicate that endogenous melatonin sleep-promoting action seems to be compromised in schizophrenia.
本研究旨在比较精神分裂症患者与健康对照组的内源性褪黑素的促眠作用。
本研究纳入 34 名精神分裂症门诊患者（SP）和 34 名健康受试者（HS）。腕动描记法记录和睡眠日记用于评估睡眠-觉醒周期。匹兹堡睡眠质量指数（PSQI）用于测量睡眠质量和模式，阳性和阴性症状量表（PANSS）用于评估精神病理学。为了量化和评估夜间褪黑素曲线，在昏暗的灯光条件下（<50 勒克斯），从 20:00 到 23:00 每小时收集一夜的唾液样本。
与 HS 相比，SP 的 PSQI 评分明显更高，表明睡眠质量更差。与 HS 相比，患者夜间睡眠时间更长，但睡眠效率更差。SP 的睡眠潜伏期和夜间觉醒次数显著更高。HS 中，褪黑素水平与睡眠潜伏期、总睡眠时间呈负相关，与睡眠效率呈正相关，但 SP 中无此相关性。
本研究结果表明，内源性褪黑素的促眠作用似乎在精神分裂症中受到损害。
