Sommeil et schizophrénie : une revue des données expérimentales

Schizophrenia, the most disabling of psychiatric diseases, is frequently associated with sleep disorders which nature and severity depend on the active/chronic phase and subtype of the disease. Experimentally schizophrenic patient's sleep is characterized by an increased latency and fragmentation leading to decrease of total sleep time and sleep efficiency, which are maximal during active phases of the disease and may persist during chronic phases. Several sleep architectural abnormalities have been reported. Schizophrenic patients with negative symptoms may have a decrease in duration and proportion of slow wave sleep. REM sleep disturbances (decrease in REM sleep duration, proportion and latency and lack of rebound after REM sleep deprivation) seem to be restricted to patients presenting severe positive symptoms, during acute phases. These polysomnographic changes tend to normalize under antipsychotic medication with the exception of the deficit in slow wave sleep. Finally, we found no evidence favoring an endogenous perturbation of the wake-sleep regulation in the literature. Indeed, most of the chronobiological changes previously reported were attributable to a disruption of wake-sleep behavioral patterns and to sedative side effects of medications. Further studies are necessary to characterize more precisely the hypnologic patterns of schizophrenics.