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Psychiatric Illness and Parasomnias: a Systematic Review

  • Sleep Disorders (P Gehrman, Section Editor)
  • Published:
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Abstract

Purpose of Review

Little is known about the presence of parasomnias such as nightmare disorder, sleep paralysis, REM sleep behavior disorder (RBD), and sleep-related eating disorders (SRED) in people with mental illness. A predominant view suggests that psychotropic medications might be contributing to parasomnias. This article summarizes knowledge regarding the relationships between psychiatric disorders and parasomnias, and possible confounds. A systematic search of the literature in the past 10 years identified 19 articles.

Recent Findings

There were significantly elevated rates of parasomnias in psychiatric disorders (average prevalence of nightmares was 38.9%, sleep paralysis 22.3%, SRED 9.9%, sleepwalking 8.5%, and RBD 3.8%). Medication usage was only one of many risk factors (other sleep disorders, medical comorbidities, and substance abuse) which were associated with parasomnias.

Summary

A strong association exists between mental illness and parasomnias which is not fully explained by medications. Prospective longitudinal studies are needed to develop a better understanding of the unique and shared variance from multiple risk factors.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Cohrs S. Sleep disturbances in patients with schizophrenia. CNS drugs. 2008;22(11):939–62.

    Article  CAS  PubMed  Google Scholar 

  2. Gruber J, et al. Sleep matters: sleep functioning and course of illness in bipolar disorder. J Affect Disord. 2011;134(1):416–20.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Soehner AM, Harvey AG. Prevalence and functional consequences of severe insomnia symptoms in mood and anxiety disorders: results from a nationally representative sample. Sleep. 2012;35(10):1367.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Waters F, et al. Daily variations in sleep–wake patterns and severity of psychopathology: a pilot study in community-dwelling individuals with chronic schizophrenia. Psychiatry Res. 2011;187(1):304–6.

    Article  PubMed  Google Scholar 

  5. Dolder CR, Nelson MH. Hypnosedative-induced complex behaviours. CNS drugs. 2008;22(12):1021–36.

    Article  CAS  PubMed  Google Scholar 

  6. Hafeez ZH, Kalinowski CM. Somnambulism induced by quetiapine: two case reports and a review of the literature. CNS spectrums. 2007;12(12):910–2.

    Article  PubMed  Google Scholar 

  7. Parish JM. Violent dreaming and antidepressant drugs: or how paroxetine made me dream that I was fighting Saddam Hussein. J Clin Sleep Med. 2007;3(5):529–31.

    PubMed  PubMed Central  Google Scholar 

  8. Seeman MV. Sleepwalking, a possible side effect of antipsychotic medication. Psychiatry Q. 2011;82(1):59–67.

    Article  Google Scholar 

  9. Administration, U.S.F.a.D. FDA requests label change for all sleep disorder drug products. in FDA News. Retrieved from http://www.fda.gov/bbs/topics/NEWS/2007/NEW01587.html. 2007.

  10. •• American Academy of Sleep Medicine (AASM) The international classification of sleep disorders: diagnostic and coding manual: American Acad. of Sleep Medicine; 2005. This manual explains practice and diagnostic parameters of sleep disorders for clinical use.

  11. Boland EM, et al. Associations between sleep disturbance, cognitive functioning and work disability in bipolar disorder. Psychiatry Res. 2015;230(2):567–74.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Chiu VW, et al. Sleep in schizophrenia: exploring subjective experiences of sleep problems, and implications for treatment. Psychiatry Q. 2016;87(4):633–48.

    Article  Google Scholar 

  13. Russo M, et al. The relationship between sleep quality and neurocognition in bipolar disorder. J Affect Disord. 2015;187:156–62.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Cretu JB, et al. Sleep, residual mood symptoms, and time to relapse in recovered patients with bipolar disorder. J Affect Disord. 2016;190:162–6.

    Article  PubMed  Google Scholar 

  15. Pressman MR. Factors that predispose, prime and precipitate NREM parasomnias in adults: clinical and forensic implications. Sleep Med Rev. 2007;11(1):5–30.

    Article  PubMed  Google Scholar 

  16. Ohayon M, et al. Prevalence and comorbidity of nocturnal wandering in the US adult general population. Neurology. 2012;78(20):1583–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Mahowald M, Cramer Bornemann M, Schenck C. State dissociation, human behavior, and consciousness. Curr Top Med Chem. 2011;11(19):2392–402.

    Article  CAS  PubMed  Google Scholar 

  18. Ohayon MM, Mahowald MW, Leger D. Are confusional arousals pathological? Neurology. 2014;83(9):834–41.

    Article  PubMed  Google Scholar 

  19. Nevéus T, et al. Sleep habits and sleep problems among a community sample of schoolchildren. Acta Paediatr. 2001;90(12):1450–5.

    Article  PubMed  Google Scholar 

  20. Goldstein CA. Parasomnias. Dis Mon. 2011;57(7):364–88.

    Article  PubMed  Google Scholar 

  21. Kierlin L, Littner M. Parasomnias and antidepressant therapy: a review of the literature. Frontiers in psychiatry. 2011;2:71.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ohayon MM, Guilleminault C, Priest RG. Night terrors, sleepwalking, and confusional arousals in the general population: their frequency and relationship to other sleep and mental disorders. J Clin Psychiatry. 1999;60(4):268.

    Article  CAS  PubMed  Google Scholar 

  23. •• Ohayon, M.M. and C. Guilleminault, Epidemiology of sleep disorders. Sleep: a comprehensive handbook, 2006. 73. This book chapter presents a recent review of the epidemiology of dyssomnias and parasomnias.

  24. •• Santin J, et al. Sleep-related eating disorder: a descriptive study in Chilean patients. Sleep Med. 2014;15(2):163–7. This study describes 34 adults diagnosed with SRED. Most had several episodes per night, and comorbidities included insomnia, restless leg syndromes, OSA, obesity, anxiety, and hypnotic medications

    Article  PubMed  Google Scholar 

  25. Postuma RB, Gagnon J-F, Montplaisir JY. REM sleep behavior disorder: from dreams to neurodegeneration. Neurobiol Dis. 2012;46(3):553–8.

    Article  PubMed  Google Scholar 

  26. Li SX, et al. Prevalence and correlates of frequent nightmares: a community-based 2-phase study. Sleep. 2010;33(6):774–80.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Simard V, Nielsen TA. Sleep paralysis associated with sensed presence as a possible manifestation of social anxiety. Dreaming. 2005;15(4):245.

    Article  Google Scholar 

  28. Levin R, Nielsen TA. Disturbed dreaming, posttraumatic stress disorder, and affect distress: a review and neurocognitive model. Psychol Bull. 2007;133(3):482.

    Article  PubMed  Google Scholar 

  29. Sandman N, et al. Nightmares: risk factors among the Finnish general adult population. Sleep. 2015;38(4):507.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Simor P, et al. Electroencephalographic and autonomic alterations in subjects with frequent nightmares during pre-and post-REM periods. Brain Cogn. 2014;91:62–70.

    Article  PubMed  Google Scholar 

  31. • Swart ML, et al. Prevalence of nightmare disorder in psychiatric outpatients. Psychother Psychosom. 2013;82(4):267–8. This study assessed 498 consecutive patients admitted to a mental health hospital. 29.9% suffered from nightmare disorder, with no association with any particular association

    Article  PubMed  Google Scholar 

  32. Niet de G, et al. Perceived sleep quality of psychiatric patients. J Psychiatr Ment Health Nurs. 2008;15(6):465–70.

    Article  Google Scholar 

  33. Sharpless BA, Barber JP. Lifetime prevalence rates of sleep paralysis: a systematic review. Sleep Med Rev. 2011;15(5):311–5.

    Article  PubMed  PubMed Central  Google Scholar 

  34. •• Lam SP, et al. Parasomnia among psychiatric outpatients: a clinical, epidemiologic, cross-sectional study. J Clin Psychiatry. 2008;69(9):1374–82. This cross-sectional study examined prevalence rate of various parasomnias and sleep disorders using structured questionnaires, interviews, and PSG. Parasomnias were linked to a constellation of sleep disturbances and combination of medications

    Article  PubMed  Google Scholar 

  35. Kircanski K, et al. Subtypes of panic attacks: a critical review of the empirical literature. Depression and Anxiety. 2009;26(10):878–87.

    Article  PubMed  Google Scholar 

  36. Benca R, et al. Psychiatric disorders. In: Principles and practice of sleep medicine. 5th ed. St. Louis, MO: Elsevier Saunders; 2011.

    Google Scholar 

  37. Otto MW, et al. Rates of isolated sleep paralysis in outpatients with anxiety disorders. Journal of anxiety disorders. 2006;20(5):687–93.

    Article  PubMed  Google Scholar 

  38. Sharpless BA, et al. Isolated sleep paralysis and fearful isolated sleep paralysis in outpatients with panic attacks. J Clin Psychol. 2010;66(12):1292–306.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Spoormaker VI, Schredl M, van den Bout J. Nightmares: from anxiety symptom to sleep disorder. Sleep Med Rev. 2006;10(1):19–31.

    Article  PubMed  Google Scholar 

  40. •• Germain A. Sleep disturbances as the hallmark of PTSD: where are we now? Am J Psychiatr. 2013;170(4):372–82. This study revisits the association between REM sleep, trauma, fear response, and memory consolidation in PTSD and concludes that targeted sleep treatments may accelerate recovery from PTSD

    Article  PubMed  PubMed Central  Google Scholar 

  41. Besiroglu L, Agargun MY, Inci R. Nightmares and terminal insomnia in depressed patients with and without melancholic features. Psychiatry Res. 2005;133(2):285–7.

    Article  PubMed  Google Scholar 

  42. •• Li SX, et al. Residual sleep disturbances in patients remitted from major depressive disorder: a 4-year naturalistic follow-up study. Sleep. 2012;35(8):1153–61. This study presents a 4-year prospective observation study in a cohort of 421 outpatients with major depression. In remitted patients, nightmares were common, as were insomnia and anxiety

    Article  PubMed  PubMed Central  Google Scholar 

  43. Sjöström N, Waern M, Hetta J. Nightmare and sleep disturbance in relation to suicidality in suicide attempters. Sleep. 2007;30:91–5.

    Article  PubMed  Google Scholar 

  44. Gangdev P, Dua V, Desjardins N. Isolated sleep paralysis and hypnic hallucinations in schizophrenia. Indian J Psychiatry. 2015;57(4):383.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Sheaves B, et al. Nightmares in patients with psychosis: the relation with sleep, psychotic, affective, and cognitive symptoms. The Canadian Journal of Psychiatry. 2015;60(8):354–61.

    PubMed  Google Scholar 

  46. • Li SX, et al. Sleep disturbances and suicide risk in an 8-year longitudinal study of schizophrenia-Spectrum disorders. Sleep. 2015;39(6):1275–82. This study examines the prevalence of sleep problems in schizophrenia and prospective association with suicide attempt. Comorbid insomnia and nightmares were associated with risk of suicide attempt at follow-up (OR 11.1)

    Article  Google Scholar 

  47. Waters F, et al. Effects of polypharmacy on sleep in psychiatric inpatients. Schizophr Res. 2012;139(1):225–8.

    Article  PubMed  Google Scholar 

  48. Palmese LB, et al. Prevalence of night eating in obese individuals with schizophrenia and schizoaffective disorder. Compr Psychiatry. 2013;54(3):276–81.

    Article  PubMed  Google Scholar 

  49. Bernert RA, Nadorff MR. Sleep disturbances and suicide risk. Sleep medicine clinics. 2015;10(1):35–9.

    Article  PubMed  Google Scholar 

  50. Abrams MP, et al. Prevalence and correlates of sleep paralysis in adults reporting childhood sexual abuse. Journal of anxiety disorders. 2008;22(8):1535–41.

    Article  PubMed  Google Scholar 

  51. Bernert RA, et al. Sleep disturbances as an evidence-based suicide risk factor. Current psychiatry reports. 2015;17(3):1–9.

    Article  Google Scholar 

  52. Koffel E, Watson D. Unusual sleep experiences, dissociation, and schizotypy: evidence for a common domain. Clin Psychol Rev. 2009;29(6):548–59.

    Article  PubMed  PubMed Central  Google Scholar 

  53. • Lancee J, Schrijnemaekers NC. The association between nightmares and daily distress. Sleep and Biological Rhythms. 2013;11(1):14–9. This study in healthy participant shows a link between nightmare, poor sleep, and next day distress

    Article  Google Scholar 

  54. Pigeon, W.R., M. Pinquart, and K. Conner, Meta-analysis of sleep disturbance and suicidal thoughts and behaviors. 2012.

  55. Roberts J, Lennings C. Personality, psychopathology and nightmares in young people. Personal Individ Differ. 2006;41(4):733–44.

    Article  Google Scholar 

  56. Benca RM, et al. Sleep and psychiatric disorders: a meta-analysis. Arch Gen Psychiatry. 1992;49(8):651–68.

    Article  CAS  PubMed  Google Scholar 

  57. Hoque R, Chesson AL Jr. Pharmacologically induced/exacerbated restless legs syndrome, periodic limb movements of sleep, and REM behavior disorder/REM sleep without flatonia: literature review, qualitative scoring, and comparative analysis. J Clin Sleep Med. 2010;6(1):79–83.

    PubMed  PubMed Central  Google Scholar 

  58. Agargun MY, et al. Nightmares, suicide attempts, and melancholic features in patients with unipolar major depression. J Affect Disord. 2007;98(3):267–70.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. School of Psychological Science, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia

    Flavie Waters

  2. Clinical Research Centre, Graylands Hospital, North Metropolitan Health Service–Mental Health, Perth, Western Australia, Australia

    Flavie Waters

  3. Psychiatric Unit I Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa, Italy

    Umberto Moretto

  4. Center for Studies in Behavioral Neurobiology & PERFORM Center, Department of Exercise Science, Concordia University, 7141 Sherbrooke St. West, SP 165.27, Montreal, H4B 1R6, Canada

    Umberto Moretto & Thien Thanh Dang-Vu

  5. Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal (CRIUGM), 4545 chemin Queen-Mary, M5815, Montreal, H3W 1W5, Canada

    Umberto Moretto & Thien Thanh Dang-Vu

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  1. Flavie Waters
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Correspondence to Flavie Waters.

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This article is part of the Topical Collection on Sleep Disorders

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Waters, F., Moretto, U. & Dang-Vu, T.T. Psychiatric Illness and Parasomnias: a Systematic Review. Curr Psychiatry Rep 19, 37 (2017). https://doi.org/10.1007/s11920-017-0789-3

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  • DOI: https://doi.org/10.1007/s11920-017-0789-3

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