| BackgroundSchizophrenia often associated with sleep disorders, the incidence of which is as high as30-80%. Long lasting sleep disorders can affect the treatment effect and congnitive function, even may lead to suicide for schizophrenia patients.ObjectivesTo explore the differences in sleep PSG between first-episode schizophrenia and normal controls, and observe the subjective and objective sleep improvement of two new antipsychotic drugs risperidone and quetiapine flat for patients with first-episode schizophrenia by observing the first-episode schizophrenic patients more figure indicators. It will explore new ideas and find theoretical support for the clinical treatment of schizophrenia (improve positive and negative symptoms as well as sleep disorders of schizophrenic patients).Methods1.91patients with schizophrenia meeting the schizophrenia criterion of International Classication of Diseases-10were enrolled into the study. They were divided into two groups according to the random number table method of admission quetiapine group including46cases and risperidone group including45cases.40health control group were intern students and volunteers.2. Using the Positive and Negative Syndrome Scale (PANSS) to test all subjects before enrolling into the study and after4weeks taking medicine. Using the polysomnography (PSG) to test the sleep quality of all subjects before enrolling into the study and after4weeks taking medicine. Using Pittsburgh sleep quality index (PSQI) to test the subjects on the second day of polysomnography (PSG).3. Both groups are begin with small doses of medication. Quetiapine group gradually adjusted to the effective therapeutic dose of400-600mg/d, Risperidone group gradually adjust to the effective therapeutic dose of2-6mg/d.4. All data were processed by SPSS15.0statistical package, measurement data using t test and count data using χ2test.Results1. After4weeks, the efficiency of risperidone group was76.75%, the efficiency was95.35%, the efficiency of quetiapine group was79.07%, the efficiency was97.67%, there wes no statistically significance (χ2value was0.068and0.345, respectively, P value was0.795and0.557, respectively).There was a significant difference in PANSS score of both quetiapine group and risperidone group after4weeks compared with before taking the medicine (P<0.05). There was no significant difference in two groups before taking the medicine and after taking the medicine (P>0.05).2. The PSG recording showed that in comparison with the normal control group the total sleep time of the schizophrenia patients was shorter, sleep efficiency was lower, awakening time was longer, stage1(S1) time was longer, rapid eye movement sleep time,S3and S4time was shorter, rapid eye movement sleep latency was shorter, however, there was not significant difference in S2time.3. The baseline PSG recording showed no significant difference in baseline values between quetiapine group and risperidone group before treatment (P>0.05).In comparison with before taking medicine, the total sleep time of the schizophrenia patients was longer, sleep efficiency was higher, awakening time was longer, S1time was longer, S2,S3and S4time was longer after4weeks quetiapine treatment (P<0.01).After4weeks treatment, the total sleep time of the schizophrenia patients was longer, sleep efficiency was higher, awakening time was longer, S1time was shorter, rapid eye movement sleep time was longer, rapid eye movement sleep latency was longer (P<0.01), S2time was longer after4weeks risperidone treatment (P<0.05). There was not significance in the rest of the index (P>0.05).4. After4weeks treatment, there was significant statistical difference in rapid eye movement sleep time and slow wave sleep time between two groups (P<0.01), and rapid eye movement sleep latency showed statistical difference (P<0.05). There was not significant difference in the rest of the index (P>0.05).5. Before medication, There was no statistical significance on the diffrernce between risperidone and quetiapine groups in PSQI scores, sleep quality, sleep time, sleep time, sleep efficiency differences, sleep disturbances and daytime function.(P>0.05).There was a significant difference in PSQI scores between quetiapine group and risperidone group after4weeks treatment (P<0.01).There was a significant difference in PSQI scores, sleep quality, sleep time (P<0.01), sleep disorders (P<0.05) between quetiapine group and risperidone group after4weeks treatment. There was not significant difference in the rest of the index (P>0.05).Conclusions1. There are abnormity of sleep structure and sleep continuity in schizophrenia patients.2. Both risperidone and quetiapine can improve subjective and objective sleep quality in the patients with first-episode schizophrenic.3. For the objective sleep quality, risperidone in increasing rapid eye movement sleep time and rapid eye movement sleep latency is better than quetiapine, however, quetiapine is better in increasing slow wave sleep time.4. Quetiapine flat can weaken the feeling of the subjective sleep disorders in patients compare with risperidone flat. |
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