Paper
Tuesday, July 8, 2008
This presentation is part of : Strategies to Improve the Health of Adult Patients with Schizophrenia
Effects and Adverse Reactions of Benzodiazepines on Sleep Quality of Adult Patients with Schizophrenia: An Evidence-Based Review
Kwang Ghee Tey, RN, RMN, BHSc(Nursing), Department of Nursing, Institute of Mental Health/Woodbridge Hospital, Singapore, Singapore
Learning Objective #1: discuss effects and adverse reactions of benzodiazepines on sleep quality of adult patients.
Learning Objective #2: identify directions for future research.

Background.Sleep disturbance appears to be widespread among patients with schizophrenia. Often, Benzodiazepines are prescribed to these patients to improve their sleep quality and maintain sleep patterns. However, many studies show that benzodiazepines have several adverse reactions that may lead to dependence, reduction in psychomotor performance, poor cognitive and physical functioning.

Aim.This paper reviews the effects and adverse reactions of benzodiazepines in improving sleep quality among adult patients with schizophrenia.

Search strategy.Ovid Medline (1996 to November2007), Cumulative Index of Nursing and Allied Health Literature, Conchrane Central Register of controlled trials and Journals@Ovid Full Text were searched for randomized control trials that compared adverse reactions of benzodiazepine to sleep quality in patients with schizophrenia. Search terms including “benzodiazepine”, “sleep quality”, “sedation”, “schizophrenia” and “adverse reaction” were used. The references of all studies were searched for further trial citations and supplement articles. Data were analyzed separately from each of the study for objectivity.

Results.Preliminary findings show that some studies suggested that benzodiazepines were associated with an increased risk of falls, hip fractures and cognitive impairment. Few studies showed that patients on benzodiazepine reported adverse reactions, such as daytime drowsiness, dizziness (common odds ratio 1.8, 95% CI 1.4 to 2.4). While, other studies showed that there was a significant (P < 0.05) reduction in sleep onset latency and number of nocturnal awakenings in hospitalized patients on benzodiazepines. There were no changes in sleep duration and overall quality of sleep. No similar or related studies had been conducted for patients suffering from schizophrenia. Conclusion.Benzodiazepines have adverse reactions that may reduce both cognitive and physical functioning. Despite of this, its effects and adverse reactions on patients with schizophrenia remain inadequately studied. More future related studies should be conducted on these vulnerable patient populations, so as to ensure safer treatment alternatives can be discovered and offered.