Psychiatric Disorders Associated with Disturbed Sleep

ABSTRACT

Disturbed sleep is a feature of many psychiatric disorders. When clinicians are investigating insomnia, excessive daytime sleepiness, as well as parasomnia, they need to consider whether these complaints might be secondary to a psychiatric process. The association that is best supported by scientific evidence is between insomnia and mood disorders. Nonetheless, other psychiatric conditions including anxiety, psychosis, chemical dependency, and attention deficit hyperactivity disorder are closely linked with alteration in sleep quality and quantity. Treatment plans should take into account the nature of sleep symptomatology as well as the effect of medications on sleep. Ideally, management should include a combination of medications and behavioral treatment.

Insomnia - depression - anxiety - psychosis - alcohol dependence - attention deficit hyperactivity disorder

REFERENCES

• 1 American Psychiatric Association .Diagnostic and Statistical Manual of Mental Disorders. In: First M Washington, DC; American Psychiatric Association 1994: 886
• 2 Buysse D, Reynolds C, Kupfer D et al.. Clinical diagnoses in 216 insomnia patients using the International Classification of Sleep Disorders (ICSD), DSM-IV and ICD-10 categories: a report from the APA/NIMH DSM-IV Field Trial.  Sleep. 1994;  17 630-637
• 3 Mellinger G, Balter M, Uhlenhuth E. Insomnia and its treatment.  Arch Gen Psychiatry. 1985;  42 225-232
• 4 Ford D, Cooper-Patrick L. Sleep disturbances and mood disorders: An epidemiologic perspective.  Depress Anxiety. 2001;  14 3-6
• 5 Rodin J, McAvay G, Timko C. A longitudinal study of depressed mood and sleep disturbances in elderly adults.  J Gerontol. 1988;  43 P45-P53
• 6 Giles E, Kupfer D, Rush A. Controlled comparison of electrophysiological sleep in families of probands with unipolar depression.  Am J Psychiatry. 1998;  155 192-199
• 7 Buysse D, Tu X, Cherry C et al.. Pretreatment REM sleep and subjective sleep quality distinguish depressed psychotherapy remitters and nonremitters.  Biol Psychiatry. 1999;  45 205-213
• 8 Dolenc L, Besset A, Billiard M. Hypersomnia in association with dysthymia in comparison with idiopathic hypersomnia and normal controls.  Pflugers Arch. 1996;  431 R303-R304
• 9 Lewy A. Seasonal Mood Disorders. Philadelphia; WB Saunders 1993
• 10 Ohayon M, Roth T. Place of chronic insomnia in the course of depressive and anxiety disorders.  J Psychiatr Res. 2003;  37 9-15
• 11 Kessler R, McGonagle K, Zhao S et al.. Lifetime and 12 month prevalence of DSM-III-R psychiatric disorders among persons 15-54 in the United States: results from the National Comorbidity Study.  Arch Gen Psychiatry. 1994;  51 8-19
• 12 Weissman M, Bland R, Canino G et al.. The cross-national epidemiology of panic disorder.  Arch Gen Psychiatry. 1997;  54 305-309
• 13 Schredl M, Kronenberg G, Nonnell P, Heuser I. Dream recall, nightmare frequency, and nocturnal panic attacks in patients with panic disorder.  J Nerv Ment Dis. 2001;  189 559-562
• 14 Stein M, Millar T, Larsen D, Kryger M. Irregular breathing during sleep in patients with panic disorder.  Am J Psychiatry. 1995;  152 1168-1173
• 15 Hauri P, Friedman M, Ravaris C. Sleep in patients with spontaneous panic attacks.  Sleep. 1989;  12 323-337
• 16 Engdahl B, Eberly R, Hurwitz T, Mahowald M, Blake J. Sleep in a community sample of elderly war veterans with and without posttraumatic stress disorder.  Biol Psychiatry. 2000;  47 520-525
• 17 Raskind M, Peskind E, Kanter E et al.. Reduction of nightmares and other PTSD symptoms in combat veterans by Prazosin: a placebo-controlled study.  Am J Psychiatry. 2003;  160 371-373
• 18 Maixner S, Tandon R, Eiser A, Taylor S, De Quardo J, Shipley J. Effects of antipsychotic treatment on polysomnographic measures in schizophrenia: a replication and extension.  Am J Psychiatry. 1998;  155 1600-1602
• 19 Nace E P. Alcoholism: epidemiology, diagnosis, and biological aspects.  Alcohol. 1986;  3 83-87
• 20 Bonora M, St. John W, Bledsoe T. Differential elevation by protriptyline and depression by diazepam of upper airway respiratory activity.  Am Rev Respir Dis. 1985;  131 41-45
• 21 Brower K, Aldrich M, Robinson E, Zucker R, Greden J F. Insomnia, self-medication, and relapse to alcoholism.  Am J Psychiatry. 2001;  158 399-404
• 22 Brower K, Hall J. Effects of age and alcoholism on sleep: a controlled study.  J Stud Alcohol. 2001;  62 335-343
• 23 Montagna P, Lugaresi E. Agrypnia excitata: a generalized overactivity syndrome and a useful concept in the neurophysiology of sleep.  Clin Neurophysiol. 2002;  113 552-560
• 24 Liappas I, Malitas P, Dimopoulos N et al.. Zolpidem dependence case series: possible neurobiological mechanisms and clinical management.  J Psychopharmacol. 2003;  17 131-135
• 25 Poyares D, Guilleminault C, MM O, Tufik S. Can valerian improve the sleep of insomniacs after benzodiazepine withdrawal?.  Prog Neuropsychopharmacol Biol Psychiatry. 2002;  26 539-545
• 26 Rowland A, Lesesne C, Abramowitz A. The epidemiology of attention-deficit/hyperactivity disorder (ADHD): a public health view.  Ment Retard Dev Disabil Res Rev. 2002;  8 162-170
• 27 Chervin R, Dillon J, Bassetti C, Ganoczy D, Pituch K. Symptoms of sleep disorders, inattention, and hyperactivity in children.  Sleep. 1997;  20 1185-1193