Treating Sleep Spindle Deficits in Schizophrenia: Eszopiclone vs. Auditory Rhythmic Stimulation

Date of Award

Spring 2021

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

ToriAnne Yetter, MSPAS, PA-C

Abstract

Introduction: Schizophrenia is a neurodevelopmental disorder marked by distorted thoughts often leading to social and vocational disability. Deficits in sleep spindles, oscillations during slow wave sleep, are also seen in schizophrenia and are believed to contribute to cognitive impairments, and so enhancing sleep spindles is a potential mechanism for improving cognition. This review analyzes the utility of pharmacologic and non-pharmacologic treatments in patients with schizophrenia (P), primarily eszopiclone (I) versus auditory stimulation (C) in reducing sleep spindle deficits (O).

Methods: A literature search conducted in November 2019 using PubMed and Cochrane Library researched sleep spindle treatments to yield seven articles relevant to the use of eszopiclone or auditory stimulation in patients with schizophrenia. Articles were chosen based on date, relevance, intervention, and study design.

Results: The appraised studies demonstrated two major findings. Firstly, sleep spindle deficits are correlated with sleep-dependent memory and negative schizophrenia symptoms. Secondly, sleep spindles can be manipulated by eszopiclone and auditory stimuli. Auditory stimulation enhanced spindle number, density, length, and amplitude with associated improvements in sleep-dependent memory. In patients with schizophrenia, eszopiclone increased the number and density of sleep spindles while also improving sleep-dependent memory.

Discussion: Non-pharmacologic approaches provide an alternative or adjunctive option to hypnotics. Additional research is needed to establish the efficacy of auditory rhythmic stimuli, but the current literature shows promising improvements to sleep-dependent memory as a result of spindle manipulation.

Conclusion: To date, no studies tested the ability of both eszopiclone and auditory stimuli to enhance sleep spindles and decrease cognitive deficits or schizophrenia symptoms. More research is needed to outline therapeutic or adjunctive uses of auditory stimulation as well as clinical guidelines to optimize use in patients with schizophrenia.

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Treating Sleep Spindle Deficits in Schizophrenia: Eszopiclone vs. Auditory Rhythmic Stimulation

Introduction: Schizophrenia is a neurodevelopmental disorder marked by distorted thoughts often leading to social and vocational disability. Deficits in sleep spindles, oscillations during slow wave sleep, are also seen in schizophrenia and are believed to contribute to cognitive impairments, and so enhancing sleep spindles is a potential mechanism for improving cognition. This review analyzes the utility of pharmacologic and non-pharmacologic treatments in patients with schizophrenia (P), primarily eszopiclone (I) versus auditory stimulation (C) in reducing sleep spindle deficits (O).

Methods: A literature search conducted in November 2019 using PubMed and Cochrane Library researched sleep spindle treatments to yield seven articles relevant to the use of eszopiclone or auditory stimulation in patients with schizophrenia. Articles were chosen based on date, relevance, intervention, and study design.

Results: The appraised studies demonstrated two major findings. Firstly, sleep spindle deficits are correlated with sleep-dependent memory and negative schizophrenia symptoms. Secondly, sleep spindles can be manipulated by eszopiclone and auditory stimuli. Auditory stimulation enhanced spindle number, density, length, and amplitude with associated improvements in sleep-dependent memory. In patients with schizophrenia, eszopiclone increased the number and density of sleep spindles while also improving sleep-dependent memory.

Discussion: Non-pharmacologic approaches provide an alternative or adjunctive option to hypnotics. Additional research is needed to establish the efficacy of auditory rhythmic stimuli, but the current literature shows promising improvements to sleep-dependent memory as a result of spindle manipulation.

Conclusion: To date, no studies tested the ability of both eszopiclone and auditory stimuli to enhance sleep spindles and decrease cognitive deficits or schizophrenia symptoms. More research is needed to outline therapeutic or adjunctive uses of auditory stimulation as well as clinical guidelines to optimize use in patients with schizophrenia.