Clozapine and objective assessment of hypersomnolence in patients with schizophrenia: a systematic review.

IF 3.4 3区 医学 Q2 CLINICAL NEUROLOGY Journal of Sleep Research Pub Date : 2024-10-30 DOI:10.1111/jsr.14360
Clélia Quiles, Jacques Taillard, Régis Lopez, Pierre Alexis Geoffroy, Francesco Salvo, Jean-Arthur Micoulaud-Franchi
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Abstract

Clozapine is effective in treatment-resistant schizophrenia but with adverse effects including sedation. Excessive daytime sleepiness, a symptom of hypersomnolence, is the most frequently reported subjective side-effect. The aim of this systematic review was to synthesise the literature evaluating the impact of clozapine on the objective assessment of hypersomnolence in people with schizophrenia. We systematically searched databases for articles evaluating hypersomnolence with electrophysiological or psychomotor/cognitive measures in clozapine-treated patients with schizophrenia. Objective assessment of hypersomnolence was evaluated in six studies. All studies using polysomnography (PSG) found significantly longer total sleep time and shorter sleep onset latency in patients treated with clozapine at initiation of clozapine. The study with the multiple sleep latency test (MSLT) also found a shorter sleep onset latency. These observations did not persist 4-6 weeks after treatment initiation. Further investigations are needed. Longer total sleep time should be investigated with standardised long-term PSG to investigate excessive sleep quantity. Shorter sleep onset latency should be investigated with the MSLT or the maintenance of wakefulness test to investigate the excessive propensity to fall asleep or ability to stay awake. Lastly, sleep inertia should be investigated specifically in the morning.

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氯氮平与精神分裂症患者过度嗜睡的客观评估:系统综述。
氯氮平对治疗耐药性精神分裂症有效,但也有包括镇静在内的不良反应。白天过度嗜睡是嗜睡症的一种症状,也是最常报告的主观副作用。本系统综述旨在综合评估氯氮平对客观评估精神分裂症患者过度嗜睡的影响的文献。我们在数据库中系统地检索了使用电生理或精神运动/认知测量方法对接受氯氮平治疗的精神分裂症患者的过度昏睡进行评估的文章。六项研究对嗜睡症进行了客观评估。所有使用多导睡眠图(PSG)的研究都发现,在开始使用氯氮平治疗的患者中,总睡眠时间明显更长,睡眠起始潜伏期明显更短。使用多重睡眠潜伏期测试(MSLT)的研究也发现,患者的睡眠起始潜伏期更短。这些观察结果在开始治疗 4-6 周后并未持续。还需要进一步调查。应通过标准化的长期 PSG 调查总睡眠时间是否过长,以调查睡眠量是否过多。应使用 MSLT 或保持清醒测试调查较短的睡眠开始潜伏期,以调查过度入睡倾向或保持清醒的能力。最后,应在早晨对睡眠惰性进行专门调查。
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来源期刊
Journal of Sleep Research
Journal of Sleep Research 医学-临床神经学
CiteScore
9.00
自引率
6.80%
发文量
234
审稿时长
6-12 weeks
期刊介绍: The Journal of Sleep Research is dedicated to basic and clinical sleep research. The Journal publishes original research papers and invited reviews in all areas of sleep research (including biological rhythms). The Journal aims to promote the exchange of ideas between basic and clinical sleep researchers coming from a wide range of backgrounds and disciplines. The Journal will achieve this by publishing papers which use multidisciplinary and novel approaches to answer important questions about sleep, as well as its disorders and the treatment thereof.
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