Objectives : Daytime drowsiness or sedation and changes in night sleep are commonly
seen in patients treated with clozapine. There is, however, very limited informatio on
their degree and nature during the course of treatment. The purpose of this study was
to understand the sleep patterns in chronic schizophrenic patients with clozapine
treatment over a period of 24 weeks.
Method : The sleep pattern was evaluated using a set of 5-point scale questionnaire,
to record subjective impressions of the night sleep induction, maintenance and quality,
and daytime drowsiness and fatigue. In addition, unusual experiences associated with
night sleep were recorded. The sleep questionnaire was repeatedly administered at
baseline and at 1, 2, 4, 8, 12 and 24 weeks of drug treatment. At present, data on 12
patients has been collected.
Results : All the components of night sleep were significantly improved in th 1st
through the 12 th week after treatment with clozapine. Daytime drowsiness was
significantly higher in the 1st to the 2nd week after the treatment and fatigue was also
significantly higher in the 1st to the 4th week after the treatment. Eight patients
experienced noticeable increases in salivation during night sleep, and of these, one also
reported frequent nocturnal urination and even enuresis. However, all these adverse
factors did not affect the major sleep patterns.
Conclusions : These finding suggest that the beneficial effects of clozapine on night
sleep might last much longer than the undesirable effect of daytime drowsiness and
fatigue. In other words, tolerance of the hypnotic action of clozapine might develop late
and tolerance of the daytime drowsiness and fatigue might be evident earlier.
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