The secret of clozapine: to sleep while awake?

A dramatic increase in REM sleep time at the expense of slow wave sleep has been reported in patients on clozapine monotherapy (5). It is now suggested that this effect of clozapine on the sleep pattern could be due to a dissociation of the NREM/REM sleep cycle, and that the epileptogenic EEG abnormalities induced by clozapine in daytime recordings (2) would represent a dose-dependent activation on NREM sleep mechanism during wakefulness. The implications of this theory in relation to the concept of schizophrenia are discussed.