a woman with schizophrenia struggles to sleep at 3:41 in the morning

Schizophrenia and Sleep: What You Need to Know

Schizophrenia is a mental illness with several distinctive symptoms. These include delusions, hallucinations, and difficulty feeling and processing emotions. Another very common symptom is disordered sleep. The connection between schizophrenia and sleep disorders is an increasing focus for researchers. Research into the link between schizophrenia and sleep is important for several reasons. One is that poor sleep makes you feel miserable. That means it’s a quality of life issue. Another reason is that insomnia is often followed by increased psychotic symptoms. 

That’s why monitoring and improving sleeping habits might be able to help you or a loved one manage schizophrenia symptoms. For anyone with a mental disorder, the mental health benefits of a good night’s rest are enormous. Research into schizophrenia and sleep may even lead to new treatments. If you are looking for information regarding a schizophrenia treatment program, don’t hesitate to reach out to Promises Behavioral Health today at 844.875.5609.

What Does the Research Say About Schizophrenia and Sleep?

Schizophrenia, Sleep, and Circadian Rhythms

Circadian rhythms can influence a person’s sleep-wake cycles, hormones, eating habits, body temperature, and other critical bodily functions. In a 2012 study at the University of Oxford in Great Britain, researchers found that schizophrenia has a major impact on sleep. In the study, 41 people wore devices that monitored their sleeping habits. Twenty of the people had schizophrenia, while 21 were mentally healthy unemployed people. The results showed that while the mentally healthy people had regular sleep hours, the people with schizophrenia struggled with a variety of sleep abnormalities. Some people with schizophrenia slept more than normal, while others had irregular sleep patterns. Some had extreme insomnia and would often go 24 hours or more without sleeping. These problems existed regardless of mood, mental state, or the kind of treatments people received. The research showed disrupted circadian rhythms in people with schizophrenia. The circadian rhythm is a natural process that regulates when people sleep and wake. For most people, this means sleeping at night and being awake during the day. For people with schizophrenia, however, this healthy sleep rhythm is disrupted. Their brain doesn’t distinguish sleeping hours from non-sleeping hours as easily.

Why Do People with Schizophrenia Have Trouble Sleeping?

The reason why schizophrenia causes sleep problems isn’t well understood. Research points to dysfunction of the dopamine D2 receptor as a possible cause. This dysfunction causes the dopamine receptors to be overactive. This is linked to many of the symptoms of schizophrenia, including sleep disruption. There is also evidence that serotonin dysfunction plays a role in schizophrenia and the sleep disturbances it causes. No single gene is known to be responsible for schizophrenia. Instead, several genetic and other factors likely contribute to the illness. In studies exploring genetic variations in patients with schizophrenia, a few common genes were identified. These include mutations in genes relating to various kinds of sleep disorders. For instance:

  • CLOCK (circadian locomotor output cycles kaput). This gene influences how circadian cycles are regulated.
  • BTBD9 and TH. These are genes associated with restless leg syndrome.
  • MTNR1A. This gene is associated with melatonin, the hormone that regulates sleep cycles.
  • Various other genes are involved in the regulation of circadian rhythms or neurotransmitters.

Schizophrenia Is Linked to Several Types of Sleep Disturbances

People with schizophrenia have irregular sleep patterns and a higher risk of other sleep problems. These include:

  • Restless leg syndrome and periodic limb movement disorder both cause involuntary movement during sleep. This contributes to reduced sleep quality and quantity.
  • Obstructive sleep apnea is more common in people with schizophrenia. This may be because many antipsychotic drugs cause weight gain, as obesity is a risk factor for sleep apnea.

How Can You Improve Sleep Quality?

When you have schizophrenia, improving your sleep quality and quantity is more challenging than it is for everyone else. This is because your ability to sleep isn’t just determined by your habits and preferences. When trying to improve your sleep, all the standard sleep hygiene rules still apply. These include:

  • Keeping to a regular sleep schedule. Go to bed at the same time each night, and try to wake up at the same time each morning.
  • Using your bedroom primarily for sleep.
  • When you can’t fall asleep, get out of bed and do a quiet activity such as reading or listening to relaxing music. Go back to bed when you feel sleepy.
  • Exercise during the day.
  • Avoid caffeine as much as possible, especially during the afternoon and before bed.

When you have schizophrenia, these kinds of behaviors may not “fix” your insomnia, but they are your first line of defense against sleep disturbances. Still, there are other things you can do to help increase the amount of sleep and rest you get.


Medication can be an effective way to manage sleep problems. There are a couple of downsides, however. One is that some medications are addictive. Another is that many people with schizophrenia find it hard to take medication regularly. Some options for medication to treat sleep problems include:

  • Antipsychotics such as paliperidone and olanzapine can reduce insomnia in people with schizophrenia.
  • Zopiclone and eszopiclone are effective sleep medications but are highly addictive, so they are often prescribed sparingly.
  • Melatonin, a non-addictive hormone that helps regulate the sleep cycle, may help some people with schizophrenia, improving the quality and quantity of sleep.

Talk to your doctor about the possibility of treating your sleep problems with medication. They will know the pros and cons of these medications and the unique challenges of your situation.

Alternatives to Medication

Some people with schizophrenia develop negative associations with sleep. For instance, worrying about insomnia can make it even harder to get quality sleep. This may mean that medication is less helpful because their negative thoughts about sleep lead them to avoid it. If you’re having these problems, therapy may be a more helpful strategy than medication. For instance, cognitive behavioral therapy can help people change how they think about sleep. This means negative thoughts are less likely to contribute to sleep problems.

Address Any Co-Occurring Psychiatric Disorders

It is very common for a person with schizophrenia to have other co-occurring disorders. You might be tempted to use alcohol or drugs to fall asleep. However, any substance abuse will ultimately damage your goal of healthy sleep and worsen your symptoms. In addition, post-traumatic stress disorder (PTSD) is more common in individuals with schizophrenia. Most people with PTSD will also struggle with sleeping due to a hyperarousal state. If you struggle with substance abuse or PTSD, you cannot ignore these issues. Unresolved trauma, drugs, and alcohol all cause sleep disturbances. Be honest with your doctor about any additional struggles you experience so that you can get help.

Sleep May Be Harder, But It’s Not Impossible

Most people with schizophrenia have sleep disturbances of one kind or another. The research shows that these two things are strongly linked. If you have schizophrenia, you’ll likely have sleep problems sometimes. Some treatments may help. Getting healthy sleep may be harder, but it’s not impossible. It’s worth exploring your options with your doctor to see if there’s any way you can improve the quality of your sleep.

Sleep Better Knowing You’re Supported by Promises Behavioral Health

With treatment, medication, and therapy, your schizophrenia symptoms and sleep troubles can be managed effectively and healthily. We’re here to help you. Contact us for more information about your options today at 844.875.5609

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