Chapter 7 Psychiatric disorders and sleep
Sue Wilson and
David Nutt
- • Sleep problems are common in patients with psychiatric conditions including depression, anxiety (PTSD, GAD, and panic), bipolar disorder, schizophrenia, dementia, and substance abuse
- • Insomnia is the most common sleep complaint related to psychiatric disorders; it can worsen the prognosis in mania and depression and can signal an imminent relapse
- • Sleep problems and depression are strongly linked; 775% of depressed patients have a major sleep complaint and short REM latency, decreased SWS, and increased wakefulness are present in 40–70% of depressed outpatients
- • The ability of antidepressants drugs to improve sleep early in treatment is often important to patients, particularly if insomnia causes significant distress
- • 5HT2-blocking drugs can improve subjective sleep quickly in depression; TCAs can also do this, but have more unwanted side effects
- • Worsening of symptoms in the late afternoon and evening in dementia ‘sundowning’ is a common problem
