Understanding The Link Between Schizophrenia And Sleep Disorders

Schizophrenia is a mental health disorder that can impact many aspects of a person’s life, including sleep. Individuals with schizophrenia may experience a wide range of symptoms, including positive symptoms like hallucinations and delusions, as well as negative symptoms like social withdrawal and reduced speech. The symptoms of schizophrenia and sleep disorders may be linked to one another, and in some cases, they may be bidirectional. 

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Schizophrenia and sleep disorders

Schizophrenia is a chronic and severe disorder that can affect a person’s life in many ways. The cause of schizophrenia is often complex, with genetics, environmental factors, and changes in brain structure all playing a potential role in the development of the disorder. 

A person with schizophrenia may experience many symptoms, which may include sleep disturbances. Common sleep disorders associated with schizophrenia may include the following: 

• Insomnia–Insomnia is a disorder in which a person may have a hard time falling asleep or staying asleep throughout the night. It is estimated that around 80% of individuals with schizophrenia may also experience insomnia. This may be due to overactive dopamine receptors in the brain that can cause hallucinations and make it challenging to fall asleep. Treating insomnia may involve a variety of methods, potentially including medication and therapy. 
• Hypersomnia–For individuals with schizophrenia who are taking antipsychotic medication, disturbed sleep can also include sleeping too much or experiencing excessive daytime sleepiness (hypersomnia). Individuals with psychosis due to schizophrenia have also reported excessive sleeping in some studies. 
• Sleep apnea–Individuals with schizophrenia may be more likely to be obese or overweight, which has been linked to higher rates of obstructive sleep apnea.  
• Circadian rhythm disorder–Sleep and circadian rhythms are usually connected, and a circadian rhythm disruption or disorder can impact a person’s sleep quality. Individuals with schizophrenia may experience circadian rhythm disorders at a higher rate than those without the disorder, contributing to potential sleep problems. 
• REM sleep behavior disorder–Rapid eye movement, or REM, is a part of the sleep cycle that typically helps the brain process information into long-term memory. The REM cycle usually begins around 90 minutes after sleep onset. Individuals with schizophrenia may experience less REM sleep due to sleep disruptions throughout the night. 

The bidirectional relationship between sleep disorders and schizophrenia

Schizophrenia and sleep disorders may exist in a bidirectional relationship, which generally means schizophrenia may impact sleep patterns, and sleep patterns may impact symptoms of schizophrenia. 

There also may be changes in the brain and nervous system that result from disrupted or disturbed sleep in individuals with schizophrenia, which can impact sleep efficiency. Sleep abnormalities can inhibit certain brain processes that usually occur during sleep, which can impact schizophrenia symptoms. 

Treatment for schizophrenia may include antipsychotic medications. These medications sometimes have side effects that can negatively impact sleep. Insomnia, sedation, and other sleep disorders have been linked to antipsychotic medications in some studies. Therefore, it can be important for people with schizophrenia to work closely with their psychiatrist or doctor when taking medication, as these professionals can monitor side effects and make adjustments as needed. 

Impact on mental health and daily functioning

Many people with schizophrenia may experience a sleep disturbance. A sleep disturbance may lead to lower quality sleep or getting less sleep than normal, which may worsen symptoms of schizophrenia, like hallucinations and delusions.

Sleep disturbances can also impact overall cognitive function. When an adult gets less than the recommended amount of sleep, it can impact working memory and overall executive function, which can make it more challenging to complete tasks at work or school and may lead to an increase in stress. This added stress and anxiety can increase symptoms of schizophrenia for some individuals, which may perpetuate the cyclical nature of sleep disorders and schizophrenia. 

Management and treatment strategies

For some individuals with schizophrenia and sleep disturbances, treatment may involve medication to improve sleep. Some studies have demonstrated sleep improvements with supplements like melatonin, but more research is likely needed. In many cases, individuals with schizophrenia may already be taking antipsychotic medications, so many psychiatrists and doctors may be hesitant to add another medication. Always speak to your doctor before starting, stopping, or changing the way you take any type of medication or supplement.

Outside of pharmacological approaches, a team of health professionals may recommend the following approaches to managing sleep disturbances and disorders:

• Practicing good sleep hygiene–Avoiding screen time and stimulants like caffeine before bedtime can help individuals fall asleep and stay asleep. It also may be beneficial to create a sleeping environment that is quiet and dark to promote better sleep. 
• Mindfulness–A therapist can help a person with schizophrenia work on mindfulness techniques designed to focus their attention and improve relaxation. Some strategies could include deep breathing, meditation, or progressive muscle relaxation. 
• Exercise–Exercise can improve overall sleep. A doctor or mental health professional may recommend an exercise routine to improve sleep and symptoms of schizophrenia. 
• Cognitive behavioral therapy (CBT)–CBT is a type of therapy primarily designed to identify and replace negative or unhelpful thought processes. Through CBT, a therapist may help individuals restructure thoughts that may make it challenging to fall and stay asleep.  
• Maintaining nutrient-rich eating habits–Some studies show that eating habits may be linked to sleep quality. Working with a doctor or registered dietician to explore the effects of eating habits on sleep and schizophrenia may be beneficial. 
• Developing routines and creating a sleep schedule–For some individuals, developing an end-of-day or bedtime routine can be beneficial. This can reduce stress and anxiety and serve as a reliable part of a person’s day, which may encourage sleep. It can also be beneficial to develop a sleep schedule by falling asleep and waking up at set times. 

For individuals with schizophrenia, developing a multidimensional approach to sleep and overall symptom reduction may be beneficial. This may include working with a team of professionals to address individual needs. Online therapy can be an effective way to decrease insomnia and potentially manage symptoms of schizophrenia, although individuals experiencing acute psychotic symptoms may need to seek support in person. 

When looking for a therapist, it is often important to find a mental health professional who fits your personal needs and schedule. Online therapy can provide individuals with the flexibility to choose a suitable therapist from any location while meeting from anywhere with an internet connection.