143 In particular, the DSPS appears to be associated with present or past depression in more than 75% of patients.144 It could be hypothesized that the failure in their social life causes social withdrawal and consequently a loss of the social cues necessary to synchronize their circadian rhythm. This might lead to an even more delayed Inhibitors,research,lifescience,medical phase shift and an enforcement of the psychological characteristics of DSPS patients, such as introversion and depressive

feelings. This situation becomes a vicious circle. The advanced sleep phase syndrome is a much less prevalent entity, characterized by habitual and involuntary sleep and wake times that are at least several hours earlier than societal means. Patients complaint of earlymorning awakening, and a diagnosis of depression may be made selleck erroneously. The maladjustment of these patients to social Inhibitors,research,lifescience,medical life occurs less frequently than in DSPS, probably because societal constraints on sleep time are less

rigid than on wake time. Conclusion Even though most psychiatric patients have a complaint about sleep, a primary sleep disorder may also result in neuropsychiatrie complications. Assessment of psychiatric status in patients with organic sleep disorders is necessary to optimize Inhibitors,research,lifescience,medical treatment strategies. An adequate assessment of psychiatric manifestations should be part of their sleep evaluation. Psychiatrists need to be alert to the possibility that patients who present with cognitive and/or affective disorders may have an organic sleep Inhibitors,research,lifescience,medical disorder such as OSAS, narcolepsy, or RLS/PLMD. In particular, an organic sleep disorder should be considered in the differential diagnosis of atypical or resistant psychiatric disorders. Selected abbreviations and acronyms CPAP continuous positive airway pressure DSPS delayed sleep phase syndrome MMPI Minnesota Multiphasic Personality Inventory OSAS Inhibitors,research,lifescience,medical obstructive

sleep apnea/hypopnea syndrome PLMD periodic leg movement disorder PLMS periodic leg movements during sleep REM rapid eye movement RLS restless legs syndrome SF-36 Short Form 36 Health Survey
Since the discovery by Kupfer and Foster1 of a link between depression and a shorter Interval between sleep onset from and the first episode of rapid eye movement sleep (REMS) than In controls, the relationship between psychiatric disorders and sleep has been the focus of intense research. Twenty years later, the results of a large meta-analysis2 could be summarized as follows. The sleep of depressive patients is usually accompanied by several anomalies when compared with controls: (1) increased sleep onset latency; (ii) increased percentage of REMS; (iii) increased REMS density; (iv) decreased sleep maintenance; (v) decreased percentage of slow-wave sleep (SWS); and (vi) shortened REMS latency (RL).