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Psychiatric disorders and sleep 

Psychiatric disorders and sleep
Chapter:
Psychiatric disorders and sleep
Author(s):

Dr Sue Wilson

and Prof. David J. Nutt

DOI:
10.1093/med/9780199674558.003.0007
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date: 03 April 2020

- 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

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