Schizophrenia is a mental health disorder that is characterized b y hallucinations, delusions, and disorganized or paranoid thinking. 

This condition is lifelong, and often needs treatment for the entirety of one's life. Schizophrenia first appears in one's mid 20s, but it can occur earlier or later. 

Some original symptoms include disruption to your usual sleep pattern and can lead to insomnia and increased sleep latency. Circadian rhythm disruption is also an early sign of schizophrenia and can appear prior to any delusions, hallucinations, or other noticeable symptoms. 

The relationship between schizophrenia and sleep are closely related, and understanding the relationship may help with management and treatment. Continue reading to find out more about this relationship. 

Schizophrenia and sleep 

Individuals with schizophrenia are at an increased risk for sleep disturbances. This may be due to a genetic mutation that may cause circadian rhythm disruptions AND schizophrenia. But other sleep disorders are also common in 30-80% of schizophrenia patients. A lack of sleep can make it difficult for the body and brain to function. 

A lack of sleep can further contribute to the symptoms of mental health conditions, including schizophrenia. This can make all of the issues harder to manage, even with medication management. Some symptoms impacted by sleep are: 

• disorganized thought
• memory difficulties 
• difficulty concentrating 
• difficulty expressing thoughts
• trouble focusing 
• hallucinations 
• delusions 
• anger, sadness, and other emotions out of context to the situation 

All of these symptoms can weaken the effect of medication management and stall treatment. Also, sleep disturbances are also bad for health, and not just schizophrenia symptoms. Some health issues with sleep deprivation include weight gain, hypertension, increased susceptibility for illnesses and a higher risk for diabetes. Having these additional health problems can further complicate treatment for schizophrenia. 

Common sleep disturbances in schizophrenia 

Insomnia

Insomnia is a common sleep disorder that describes trouble falling asleep, staying asleep, or sleeping all the way through the night. It can be primary or secondary, meaning there is not an underlying cause or there is, respectively. Insomnia can also be classified as being acute or chronic. 

Insomnia is problematic because it can lead to excessive daytime sleepiness, which can cause issues with executive functioning, mood regulation, and motivation or focus. Many of these disturbances are already present with schizophrenia, and insomnia may compound issues to make management extremely difficult. 

The main cause of insomnia in people with schizophrenia is dopamine. Dopamine is a brain chemical that your body uses to send signals between nerve cells. It can affect mood, memory, coordination and other important functions. 

High dopamine activity is linked to several mental health conditions, and since insomnia and schizophrenia both are caused by high levels, it can be extremely difficult for people with both manage their symptoms. 

OSA

Obstructive sleep apnea, or OSA, is a condition that arises when the airway becomes blocked throughout the night, leading to brief pauses in breathing. The body must rouse to begin breathing again, which interrupt sleep, unbeknownst to the person.

There are low levels of oxygen throughout the night, and OSA is linked to heart disease, diabetes, hypertension, and other health issues. Again, by compounding these health issues with schizophrenic management, it can become increasingly difficult to treat all of those issues. 

Signs of OSA include snoring, excessive daytime sleepiness, choking, fatigue, poor sleep, and headaches. About 15% of people with schizophrenia experience OSA. Schizophrenia medications can lead to weight gain, which is a risk factor for OSA. 

RLS/PLMD

Restless leg syndrome (RLS) is a condition that causes an uncontrollable urge to move one's legs. It typically worsens in the evenings can cause frustrating sleep disturbances. 

Periodic limb movement disorder is a cramping or jerking of the legs during sleep. It can co-occur alongside RLS or other sleep disturbances, but also can happen on its own.

People with schizophrenia often have both, and again, this can be influenced by high levels of dopamine. 

Circadian rhythm disorders 

A circadian rhythm disorder is a condition that makes it difficult to sleep on a standard 24-hour schedule. This can mean sleeping too much, too little, only being able to sleep for a short amount of time or not being able to maintain a daily schedule. 

It's common for individuals with mental health disorders to experience circadian rhythm disorders, especially those with schizophrenia. As mentioned before, it can even be an early sign that someone is developing schizophrenia. 

Narcolepsy

Narcolepsy is a neurological condition that causes you to feel very tired during the day. It can be hard to stay awake, and people with narcolepsy can feel overwhelming urges to fall asleep throughout the day.

There may be a link between narcolepsy and schizophrenia, but it has not been well studied. However, there may be an overlap with some of the symptoms, including hallucinations as both disorders have some sort of hallucinatory symptoms.

Night-eating syndrome 

Night eating is a condition that causes one to feel excessively hungry throughout the night. This means that these individuals will eat throughout the night and then aren't hungry during the day. There was a study that found that those with schizophrenia may be at higher risk for NES, and those who are overweight, obese, or have insomnia could be at a higher risk. 

Diagnosing sleep disorders should be done as soon as possible. So, if you or someone you know has schizophrenia, and possible another sleep disorder, then that needs to be taken care of right away. Diagnosing may include a questionnaire, sleep diary, sleep study or sleeping with a monitoring device. 

Treating sleep disorders that co-occur

Treating sleep disorders is coupled with treatment of schizophrenia to ensure that conflicting management practices are not being prescribed. Psychiatrists and other members of the healthcare team will work together to ensure a seamless plan that addresses both issues. 

Treatment options may include cognitive behavioral therapy, antipsychotic medications, non stimulating sleeping medications, and lifestyle changes. Work together with the healthcare team to curate a plan that is individualistic, and address the major concerns and issues. Treating the sleep disorder may indirectly improve some of the schizophrenic symptoms, and vice versa. 

If you do not have someone to help manage your sleep disorders, or you are unsure if you have one, please click the orange button to take a free online sleep test and talk with one of our sleep health professionals. 

https://www.healthline.com/health/schizophrenia/schizophrenia-and-sleep#treatment