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An algorithmic approach to the management of insomnia in patients with schizophrenia.

Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists
May 1, 2017
Ridha Joober et al. (4 authors)
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the effectiveness of melatonin in treating insomnia among patients with schizophrenia spectrum disorders.

Results Summary

The study found that melatonin yielded significant results in short-term trials, improving both subjective and objective insomnia symptoms in patients with schizophrenia.

Population

Patients with schizophrenia spectrum disorders experiencing insomnia.

Effective Dosage

Not specified

Duration

Short-term (exact duration not specified)

Interactions

None mentioned

Extracted Claims (3)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Cognitive-behavioral therapy for insomnia
decrease
insomnia
patients with schizophrenia spectrum disorders
-
shows promising results
#1
eszopiclone
decrease
subjective and objective insomnia symptoms
-
-
yielded significant results
#2
melatonin
decrease
subjective and objective insomnia symptoms
-
-
yielded significant results
#3
Abstract

BACKGROUND: Insomnia is an important problem in patients with schizophrenia and is an emerging area of interest for researchers. We propose a treatment algorithm that synthesizes the various psychological and pharmacological interventions for insomnia in this population. METHODS: Our selective literature review incorporates English language articles from 4 medicine databases through May 2016. Selected articles discuss risk factors and treatments for insomnia, as well as comorbid sleep disorders that coexist in this population. RESULTS: Various lifestyle factors and comorbid sleep disorders may predispose patients with schizophrenia to insomnia. Cognitive-behavioral therapy for insomnia shows promising results in treating insomnia in patients with schizophrenia spectrum disorders. Additionally, studies of eszopiclone and melatonin have yielded significant results in short-term trials that evaluated both subjective and objective insomnia symptoms. CONCLUSIONS: We have summarized the relevant literature regarding the treatment of insomnia in this patient population and propose an algorithm comprising 6 sequential steps, beginning with the assessment of sleep complaints and medication adherence. This is followed by a targeted treatment of any co-occurring sleep disorders, and ends with psychoeducation, cognitive-behavioral therapy, and pharmacotherapy. This algorithm provides a detailed guideline to improve the assessment and therapeutic intervention for managing insomnia among patients with schizophrenia.

Medical Subject Headings (MeSH)
AlgorithmsCognitive Behavioral TherapyDisease ManagementHumansPsychotropic DrugsSchizophreniaSleep Initiation and Maintenance Disorders
Study Links
PubMed ID28463346
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality70/10
Citation Metrics
Total Citations6
Citations/Year0.8
Relative Citation Ratio0.34
NIH Percentile17.8%
Research Impact Scores
APT Score0.25
Weight Score1.68
Normalized Score0.64
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An algorithmic approach to the management of insomnia in pat... | Panacea Index