ABSTRACT
This chapter reviews the nature of slow-wave sleep (SWS), rapid eye movement (REM) sleep, and sleep spindles, the state of knowledge in regard to the alterations in sleep architecture, the relationship between antipsychotic medications and sleep, and the neurobiology of such impairments in schizophrenia. Sleep deprivation provides a naturalistic, physiologic challenge for the dynamic manipulation of sleep processes, and can help clarify the primary nature of sleep abnormalities. Sleep deprivation studies can also help clarify whether SWS abnormalities in schizophrenia are secondary to pathology in neuronal circuits in this disorder, or whether they reflect primary homeostatic disruption in sleep processes. Activation of the cholinergic system facilitates arousal and enhances REM sleep. In summary, sleep disturbances are pervasive and cause substantial subjective distress as well as disability in schizophrenia. New knowledge regarding the brain mechanisms of sleep is likely to open new avenues for exploring such relationships.
