Sleep Disorder

Sleep disorders (SDs), including insomnia, hypersomnia, and delayed sleep phase, are common symptoms in patients with various disorders and the general population. Epidemiological data indicate that the prevalence of various SDs in the general population ranges from 0.047 to 50.5%. The most common SD is insomnia followed by sleep apnoea, restlessness syndrome, nightmares, sleep talking, sleepwalking and narcolepsy.

Causes of Psychotic Disorder

Sleep is divided into two periods according to changes in eye movement: non-rapid eye movement (NREM) and rapid eye movement (REM). Persons with SD normally have sleep-wake complaints of dissatisfaction in the quality, timing, and amount of sleep. The consequences of sleep-wake disorders are daytime distress and impairment of sleep. Persistent sleep disturbances including insomnia and excessive sleepiness are confirmed as risk factors for later development of mental illness and substance abuse disorders. Long-term SDs cause anxiety, depression and/or fear and can lead to decreased mental activity and increased risks of cardiovascular disease, dementia, mental illness, and hypogonadism.

Dopamine (DA) and Glutamate in Psychotic Disorder

GABA, melatonin, and orexin receptors are known as pharmacodynamic targets for behavioral therapies that combat insomnia. The GABA receptor is a gated chloride channel receptor, which can induce rapid inhibitory post synaptic potential (IPSP). Most of the target sites of sleeping tablets are benzodiazepine binding sites on the GABA receptor. When the signaling of the GABA receptor is weakened, sleep maintenance will also be shortened. In addition, 5-HT is a neurotransmitter widely distributed in the central nervous system of mammals and is involved in sleep-wake cycle regulation. Injecting 5-HTP or 5-HT1A receptor agonists increases slow-wave sleep (SWS) and reduces sleep latency in mammals. By targeting the receptor, it also has a variety of biological activities such as anti-oxidation, cell protection, anti-proliferation, anti-inflammatory, sedative, and hypnotic, and reduces the complications of sleep disorders.

Fig.1 Illustration of the mechanisms in sleep disorder. (Guo, 2020)

Treatment Methods of Psychotic Disorder

Sedative-hypnotic drugs, including benzodiazepines and non-benzodiazepines, are commonly used to treat SD but are not suitable for prolonged use. In fact, patients may not be able to tolerate the various side effects of these drugs, which include rebound withdrawal effects, disturbed sleep structure, drowsiness, memory disorders and bad behaviors during sleep. In addition to the abovementioned drugs, antidepressants, antipsychotics, and antihistamines can also be used to treat SD due to their sedative-hypnotic effects.

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Reference

1. Guo, J.; et al. Uncovering the pharmacological mechanism of the effects of the Banxia-Xiakucao Chinese Herb Pair on sleep disorder by a systems pharmacology approach. Scientific reports. 2020, 10(1): 1-12.