Sleep disruption is a commonly encountered clinical feature in schizophrenic patients, and one important concern is to determine the extent of this disruption under "real" life situations. Simultaneous wrist actigraphy, diary records, and repeated urine collection for urinary 6-sulphatoxymelatonin (aMT6s) profiles are appropriate tools to assess circadian rhythms and sleep patterns in field studies. Their suitability for long-term recordings of schizophrenic patients living in the community has not been evaluated. In this case report, we document long-term simultaneous wrist actigraphy, light detection, repeated urine collection, and diary records as a suitable combination of non-invasive techniques to quantify and assess changes in sleep-wake cycles, light exposure, and melatonin profiles in a schizophrenic patient. The actigraph was well-tolerated by the patient, and compliance to diary records and 48 h urine collection was particularly good with assistance from family members. The data obtained by these techniques are illustrated, and the results reveal remarkable abnormal patterns of rest-activity patterns, light exposure, and melatonin production. We observed various rest-activity patterns, including phase-shifts, highly delayed sleep on- and offsets, and irregular rest-activity phases. The period of the rest-activity rhythm, light-dark cycle, and melatonin rhythm was longer than 24 h. These circadian abnormalities may reinforce the altered sleep patterns and the problems of cognitive function and social engagement associated with schizophrenic.

译文

睡眠中断是精神分裂症患者常见的临床特征,一个重要的问题是确定在 “现实” 生活情况下这种中断的程度。同时进行腕关节活动描记术,日记记录和重复尿液收集尿6-磺胺酮 (aMT6s) 概况是评估野外研究中昼夜节律和睡眠模式的合适工具。尚未评估其对居住在社区中的精神分裂症患者的长期记录的适用性。在此病例报告中,我们记录了长期同时进行的腕关节活动,光检测,重复尿液收集和日记记录,作为非侵入性技术的合适组合,以量化和评估睡眠-觉醒周期,光照和褪黑激素的变化精神分裂症患者的概况。患者对摄动仪的耐受性良好,在家人的协助下,对日记记录和48小时尿液收集的依从性特别好。说明了通过这些技术获得的数据,结果揭示了休息活动模式,光照和褪黑激素产生的显着异常模式。我们观察到各种休息活动模式,包括相移,高度延迟的睡眠时间和偏移量以及不规则的休息活动阶段。休息活动节律,明暗周期和褪黑激素节律的时间长于24小时。这些昼夜节律异常可能会加剧睡眠模式的改变以及与精神分裂症相关的认知功能和社会参与问题。

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