Abstract
Background Insomnia is a common feature of schizophrenia. Although several studies have been
published about the influence of certain drugs on schizophrenia patients’ sleep, there
are no well-grounded recommendations about insomnia treatment in this clinical setting.
The present review aimed to identify relevant empirical evidence on available treatments
of insomnia in patients with schizophrenia, assessing their safety and efficacy.
Methods This is a systematic review of clinical trials investigating the effect of treatments
for insomnia in patients with a diagnosis of schizophrenia. Data were obtained from
Medline/PubMed, Embase, PsycInfo, and the Cochrane Library. Risk of bias was assessed
in individual studies for selection, performance, detection, attrition, and reporting
bias.
Results Four studies met inclusion criteria; 2 using melatonin, 1 using paliperidone, and
1 with eszopiclone. All reported positive results: melatonin increased sleep efficiency
and total duration of sleep; paliperidone decreased sleep latency onset and increased
total sleep time and sleep efficiency; eszopiclone decreased insomnia severity index.
Conclusions Despite a very limited number of specific studies on this matter, all 4 studies have
shown good benefit/risk ratios and reviewed options—melatonin, paliperidone, and eszopiclone—might
represent valid options for residual insomnia in schizophrenia.
Key words
schizophrenia - insomnia - sleep
