REM Sleep and Schizophrenia

Imagine that REM sleep, a process that occurs in the hippocampus, is like an airline control tower that is trying to organise the landing of airplanes into a busy airport for a short period during the night while you are sleeping. The airplanes represent many scattered emotions and non-concrete information that is spread throughout the perceptual areas of the brain. The landing of the planes is like the collection of random emotional data in the form of impulses , then sorting ,disposing or placing of data into emotional memory banks using previously stored emotional memories to assist the process. Human research supports the function of rapid eye movement (REM) sleep in memory formation. Wagner, Gais, and Born (2001) state “Results are consonant with a supportive function of REM sleep predominating late sleep for the formation of emotional memory in humans.”

Studies with deep electrodes have established that while the EEG of the neocortex is low in voltage during the REM sleep state, “the EEG of the hippocampus is increased in size at a 4-10 Hz (theta) frequency” (Siegel 2000).

Slowing of noradrenergic cells may be responsible for some of the symptoms of sleep deprivation, since norepinephrine release has been shown to increase the “signal to noise ratio” of information processing in a number of brain regions (Hasselmo et al 1997).

I hypothesize that REM sleep helps the brain regulate emotions by altering the sensitivity of D1 and/or D2 receptors. Studies have shown schizophrenics have unusual characteristics of D1 and D2 receptors (Abi-Dargham et al 2002). I suggest that in schizophrenics, REM sleep is unable to successfully carry out it’s task, resulting in an overabundance of emotional- memory-related connections and data. This initially leads to fogginess in higher thinking but ultimately to hallucinations and/or disorganized thoughts. Without proper functioning of REM sleep processes, psychosis occurs. The reason for malfunction would dictate the duration and type of psychosis. i.e. Too much emotional data overloading REM, poor foundation memories needed for sorting. Poor quality fluid and chemical combinations creating difficult pathways for impulses to leave their point of origin and head towards the hippocampus. Perhaps this creates a dream/nightmare state (Psychosis) that exists while awake?

Possible overloading reasons:

  • Sleep deprivation resulting in less REM sleep.
  • Perhaps the REM data could be too much for the REM mechanism to process during stressful times.
  • Ruminations that occur during periods of high anxiety might overload the REM process.
  • Double bind parenting could cause increased emotional stress and result in an ineffective REM process.
  • In schizophrenia and certain types of severe depression, the hippocampus shrinks.
  • Anxiety and depression can lead to psychosis due to an increase or overflow of the REM data sites.
  • Anxiety and wakening during sleep decrease the effective clearing of data sites because there is less REM sleep.
  • It’s commonly known that sleep deprivation causes psychosis, if the Rem mechanism can’t function due to lack of sleep, it overflows [rewrite]. Overloaded REM in a normal individual will spill out onto daytime wakening and perceptions in these circumstances,possibly in the areas they are waiting to be collected from.
  • Poorly functioning REM might result from nightmares which wake the person up and so they never actually continue with an adequate cleansing of the REM sites.

Perhaps hypersomnia during stressful times is an unsuccessful attempt for allowing effective REM sleep in schizophrenics.

Possible reasons for REM mechanism failure:

  • Genetic predisposition to a faulty mechanism.
  • A poorly functioning REM system could also be caused by dehydration, high fructose junk food, coca cola, coffee, cigarettes, poor vitamin intake, low phosphorus levels. Higher levels of nutrients have been shown to affect REM and are linked to better sleep.
  • Some poorly functioning REM mechanisms could be caused by maternal infections during pregnancy, head injury or other illnesses during childhood.
  • Schizophrenia might occur after childhood because the REM takes a while to become overloaded. Perhaps in some cases of high chronic stress or low mood or poor sleep REM data never completely clears so it eventually floods certain areas of the brain, polluting perceptions while the individual is awake .
  • This could explain why prodromal schizophrenics withdraw and become socially autistic, perhaps the cloudiness they complain about is like a polluted stuffiness from over stuffed REM sites that interfere with the processes necessary for the person to take in external information and separate it from their internal overflowing REM data sites.
  • Excessive intake of Junk food, high fructose diets, cola and coffee are common amongst Schizophrenics. Perhaps these diets adversely affect the mechanism or homeostasis required for emptying of the can. It could be as simple as chemical imbalances in the brain resulting in a poorly functioning REM mechanism or flow of impulses.
    • Jin et al, 2005: “Recently, considerable progress has been made in our understanding of the function and regulation of the brain-specific sodium-dependent inorganic phosphate transporter 1 (NPT1), which is found to exist principally in cerebrum and cerebellum. A high phosphate diet caused an increase in serum Pi accompanied by a decrease in calcium, and a decrease in body weight coupled with a decreased relative weight of cerebellum. A study showed the specific radioactivity of the phosphatides was depressed in sleeping as compared with waking animals. These observations suggest that the physiological conditions attributable to environmental, emotional or other determinants can influence shifts in brain metabolism during the sleep-wakefulness cycle.”
  • “Regular coffee and caffeine causes REM sleep to shift to the early part of the night and stages 3 and 4 sleep to shift to the later part” (Karakan et al, 1976)
  • Infection can lead to psychosis. “Sleep deprivation may enable bacterial growth and that sufficient sleep impedes bacterial growth. What’s even more interesting is that di-muramyl peptides created during infection enhance non-REM sleep (but not REM sleep)” (Hobson 1994). It has been shown that even after an individual has recovered from some bacterial infections the ‘dead’ bodies of the tiny bacterium still remain in the brain. This must sometimes impede certain processes or synapsing.

Other possible connections:

  • Siblings of schizophrenics often complain of vivid nightmares.
  • Post traumatic Stress disorder clients complain of terrible nightmares.
  • Antipsychotics Medications that are sedating have a faster acting effect than non-sedating antipsychotics.
  • Some antidepressants can cause psychosis and some antidepressants have been shown to block REM sleep but antidepressants given during the prodromal phase might be beneficial in decrease the workload on the emotional data sorting process.
  • Hypersomnia may be the body’s way to try to empty/sort the REM data, as is sometimes seen in mild depression or prodromal schizophrenia. Sleeping late increases REM (Plihal and Born 1997).
  • It is rare to find a schizophrenic that doesn’t smoke. “Epidemiological investigations indicate that, compared with never smokers, current smokers experience greater difficulty in initiating and maintaining sleep and are generally more dissatisfied with their sleep quality.” (Zhang et al 2006)
  • Could there be a natural steroidal effect that is produced during times of stress that potentiates psychosis by damaging the brain?
  • Perhaps individuals who are tested as genetically susceptible to schizophrenia will be able to put preventative strategies into place by altering their lifestyle.

Interesting Facts:

  • 95% schizophrenic persons smoke cigarettes.
  • Cigarettes interfere with sleep quality.
  • Nicotine patches interfere with sleep quality.
  • Research in the UK links smoking mothers to be with a 20% increase in offspring with psychosis.
  • Anti psychotic medication functions differently when a patient stops smoking.
  • Most schizophrenics drink excessive amounts of caffeine, mostly coffee and coke. In certain areas of the brain, caffeine and nicotine enhance the transmission of dopamine, the main neurotransmitter involved in schizophrenia and the site of anti-psychotic medications. When dopamine rages, it can lead to psychosis.
  • In a sample of 146 patients with schizophrenia from Pennsylvania, the rates of smoking were more than twice as high than the general United States population (59.6% vs. 23.4%). The study participants also reported smoking more cigarettes (24 vs. 13.5) and ingesting more caffeine (471.6mg vs. 254.2mg) at a rate of about ten more cigarettes and two more cups of coffee each day.
  • Caffeine interferes with the sleep process.  One recent study shows that subjects fell asleep more easily when they were not ingesting caffeine, while another other shows that the duration and quality of sleep were improved on non-caffeine days.
  • Schizophrenia is associated with increases in Dopamine whereas Parkinsons disease is associated with decreases in Dopamine.
  • A reduced risk for Parkinson’s disease (PD) among cigarettesmokers has been observed consistently during the past 30 years.Recent evidence suggests that caffeine may also be protective.
  • Poor diets deficient in certain nutrients have been shown to contribute to poor sleep.
  • Schizophrenic persons often have low nutrient diets.  Poor nutrition elevates homocysteine levels.
  • Research recently showed that Normal sleepers, consumed the highest food variety in their diets, and very short sleepers had the least variation in what they ate. A varied diet tends to be a marker for good health since it includes multiple sources of nutrients.
    Read more:
  • There has previously been found that there is a marked elevation of plasma homocysteine in young male schizophrenic patients in hospital. Serum homocysteine levels were studied in 184 consecutively admitted schizophrenic patients and 305 control subjects from an employee screening program. Homocysteine levels were markedly increased in this population of newly admitted schizophrenic patients, especially in young males. Newly admitted male schizophrenic patients have elevated homocysteine levels that cannot be explained on the basis of poor hospital nutrition. Smoking may raise homocysteine by 1–2 μM/L but this is not a large enough effect to explain our findings.
  • Some researchers have already shown a link between folic acid and schizophrenia.
  • Psychosis is usually preceded by high levels of stress.
  • Stress interferes with sleep quality.”The prevalence of insomnia may, in fact, be the result of deteriorating sleep mechanisms associated with increased sensitivity to arousal-producing stress hormones, such as CRH and cortisol.
  • During times of great stress schizophrenic persons display extremely poor sleep habits.
  • The siblings of schizophrenic persons often exhibit strange dreaming phenomena.
  • Schizophrenics often liken there symptoms to dreaming while awake.
  • Schizophrenia often appears during adolescence.
  • Adolescents have marked changes in need for length of sleep and their circadian rhythm changes.
  • Schizophrenics have biological body temperature control problems.
  • Biological body temperature regulation changes when a person is sleeping.
  • Persons abusing barbiturates become psychotic.
  • Barbiturates decrease REM sleep.
  • Heavy marijuana use is linked to psychosis and schizophrenia.
  • During discontinuation of heavy heavy marijuana use, PSG measures of sleep disturbance were detected in heavy marijuana users compared with a drug free control group.
  • New mums have lots of sleepless nights but new research suggests that a lack of sleep could place them at greater risk of suffering from postnatal psychosis.
  • Schizophrenia could simply be a sleep disorder.
  • This is to say there is an underlying belief that the area of the brain which promotes REM sleep, rapid eye movement and dreaming may also be the area that is predominantly supportive of the symptoms that manifest in the schizophrenia patient. In examining dopamine levels at the prefrontal cortex, we find the levels are significantly decreased in individuals who suffer from schizophrenia. Interesting enough, this same decrease in dopamine occurs, temporarily, during our periods of REM sleep and the onset of dreaming phases.
  • First degree relatives of schizophrenic persons often suffer from recurrent nightmares.
  • The contraceptive pill interferes with the absorption of caffeine.
  • Interesting fact, I have never known a schizophrenic to have an acute psychotic episode, while taking contraceptive pills.
  • Difficulties initiating or maintaining sleep are frequently encountered in patients with schizophrenia. Disturbed sleep can be found in 30-80% of schizophrenic patients, depending on the degree of psychotic symptomatology. Measured by polysomnography, reduced sleep efficiency and total sleep time, as well as increased sleep latency, are found in most patients with schizophrenia and appear to be an important part of the pathophysiology of this disorder.
  • Sleep disturbance is as much a part of schizophrenic disorder as it is of affective illness. Research is cited indicating that after REM deprivation, remitted schizophrenics show an abnormally large transient increase in REM sleep and that active schizophrenics have dreams that are more bland and not as well confined to REM sleep as those of normals.


  • Wagner, Gais, and Born (2001): Emotional Memory Formation Is Enhanced across Sleep Intervals with High Amounts of Rapid Eye Movement Sleep. Learning and Memory. Vol. 8, No. 2, pp. 112-119, March/April 2001
  • Siegel, J. M. Brainstem mechanisms generating REM sleep. In: Principals and Practice of Sleep Medicine, Second Edition. Edited by M. K. Kryger, T. Roth, W. C. Dement. New York: Saunders, 2000.
  • Hasselmo, Linster, Patil, Ma, and Cekic. Noradrenergic Suppression of Synaptic Transmission May Influence Cortical Signal-to-Noise Ratio. The Journal of Neurophysiology Vol. 77 No. 6 June 1997, pp. 3326-3339.
  • Abi-Dargham, Mawlawi, Lombardo, Gil, Martinez, Huang, Hwang, Keilp, Kochan, Van Heertum, Gorman, Laruelle.
    Prefrontal Dopamine D1 Receptors and Working Memory in Schizophrenia. The Journal of Neuroscience, May 1, 2002, 22(9):3708-3719
  • Isaac, and Berridge. Wake-Promoting Actions of Dopamine D1 and D2 Receptor Stimulation. Journal of Pharmacology And Experimental Therapeutics. August 27, 2003;
  • Jin, Hwang, Yu, Anderson, Lee, Lee, Prats, Morello, Beck, Jr., Cho. A High Inorganic Phosphate Diet Perturbs Brain Growth, Alters Akt-ERK Signaling, and Results in Changes in Cap-Dependent Translation. December 7, 2005. Toxicological Sciences 2006 90(1):221-229;
  • Karacan, Thornby, Anch, Booth, Williams, Salis. Dose-related sleep disturbances induced by coffee and caffeine. Clin Pharmacol Ther. 1976 Dec;20(6):682-9.
  • Hobson. “Sleep and the Immune System”. In: The Chemistry of Conscious States: How The Brain Changes. Little, Brown 1994.
  • Plihal and Born. Effects of Early and Late Nocturnal Sleep on Declarative and Procedural Memory. The Journal of Cognitive Neuroscience, Vol 9, 534-547, Copyright © 1997 by The MIT Press
  • Zhang, Samet, Caffo, Punjabi. Cigarette Smoking and Nocturnal Sleep Architecture. American Journal of Epidemiology 2006.


Acetylcholine (Ach) – the neurotransmitter in all autonomic ganglia. In other words, it is a chemical that allows neurons to communicate with each other.

Aminergic – Relating to nerve cells or fibres.

Dentate gyrus – Part of the hippocampal formation. It contains granule cells, which project to the pyramidal cells, but mostly to the interneurons of the CA3 subfield of the hippocampus.

Dopamine – dopamine functions as a neurotransmitter, activating the five types of dopamine receptor – D1, D2, D3, D4 and D5, and their variants. Dopamine is produced in several areas of the brain, including the substantia nigra.

EEG topography – using a large number of electrodes to triangulate the source of the electrical activity.

Electroencephalography – the neurophysiologic measurement of the electrical activity of the brain by recording from electrodes placed on the scalp or, in special cases, subdurally or in the cerebral cortex.

Electroencephalogram (EEG) – The resulting traces from Electroencephalography, known as an and represent a summation of post-synaptic potentials from a large number of neurons.

Entorhinal cortex (EC) – Important memory center in the brain. The EC forms the main input to the hippocampus and is responsible for the pre-processing (familiarity) of the input signals.

Hippocampus – has an essential role in the formation of new memories about experienced events (episodic or autobiographical memory).

Medulla oblongata – is the lower portion of the brainstem.

Mesencephalon (or midbrain) – is the middle of three vesicles that arise from the neural tube that forms the brain of developing animals.

Nicotinic acetylcholine receptors (nAChRs) – ionotropic receptors that form ligand gated ion channels in cells’ plasma membranes. Like the other type of acetylcholine receptors, muscarinic acetylcholine receptors (mAChRs), their opening is triggered by the neurotransmitter acetylcholine (ACh), but they are also opened by nicotine.

Noradrenergic – liberating, activated by, or involving norepinephrine in the transmission of nerve impulses

Pons – part of the central nervous system, and relays sensory information between the cerebellum and cerebrum.

Ponto-geniculo-occipital (PGO) spikes – periodically generated during the REM sleep, which are considered to be the main stimuli of dreams. Play an important role in triggering and maintaining rapid eye movement sleep. Similar potentials can be elicited in waking by intense auditory stimulation that elicit orienting

Scalp electrodes – picks up the activity of large groups of neurons

Sensory gating – a process by which the brain adjusts its response to stimuli. It is a largely automatic process. When one stimulus is presented, there is a response. But when it is followed by a second stimulus soon after, the response to the second stimulus is blunted. This is an adaptive mechanism to prevent overstimulation. It helps to focus on a stimulus among a host of other distracing stimuli. The mechanism of sensory gating involves feed-forward and feed-back inhibition of the stimulus perceived. It involves GABA-ergic and α7 nicotinergic receptor-mediated inhibition of the pyramidal neurons in the cornu ammonis (CA3) region of the hippocampus.

Theta rhythms – are one of several characteristic electroencephalogram waveforms associated with various sleep and wakefulness states.


44 Responses to REM Sleep and Schizophrenia

  1. paulie11 says:

    That makes so much sense. It would explain the prevalence, in long term hospitalizations, of the diagnosis of “schizophrenia of the bipolar type”.
    I have met many schizophrenics who have difficulty sleeping. In fact, I know one lady who takes 30 mg Temazepam, 400 mg Trazadone, 2 mg Lorazepam, and 50 mg Hydroxyzine Pamoate. That’s enough to sedate a small room full of people!

  2. kristinbell says:

    Very interesting indeed. I have schizophrenia and when I become psychotic it IS like a wakeful nightmare. You know how in dreams you do and think things that are outlandish, but they somehow all make sense in the dream? Well, psychosis is like that. Also, I don’t smoke, but I do have terrible sleep problems. I even used to sit awake in my crib at night as a baby and play with my toys. I have been diagnosed with delayed sleep phase disorder, but I’m not sure if that fully encompasses my sleep issues. I also don’t know how much the medications I am taking impact my sleep issues. Before I got sick in high school I would get about 4 hours of sleep per night, because I couldn’t fall asleep at night and I had to be up for school early. Then on the weekends I would sleep in late every day that I could. Also, I can stay awake for extended periods of time without much trouble. I usually stay up over 24 hours at least a couple of times per week. But I can also sleep a lot. I’ve even slept over 24 hours before. When I was psychotic I did stay up for the longest I’ve ever stayed awake in my life. I think I was awake for over 60 hours. I can’t recall the exact number now. I think I woke up on a Friday afternoon and didn’t sleep until Monday night. I’ve always wondered about the link between schizophrenia and sleep, especially since my psychosis is so much like dreaming.

    • Alan says:

      Very interesting article. I would agree with the postulation that suggests “perhaps schizophrenia is a sleep disorder”.

      After 9 years since being diagnosed with schizophrenia my son has seen a sleep specialist. The doctor has observed that of the 75,000 patients he has treated that his sleep apnea is one of the worst 100 cases he has witnessed.

      He has started wearing a CPAP to treat the sleep apnea and has deserved that there is a marked alteration in how he dreams while using the device. The medical professional has observed that severe sleep apnea can induce psychosis.

      It will be encouraging to see how he progresses treating an organic problem as opposed to one that has been diagnosed by behavioural observation and what the effects on his thinking are as he establishes a pattern of productive sleep. Individuals diagnosed as bipolar or schizophrenic are both susceptible to significant sleep deprivation as a prodromal to mania/ psychosis. While the causal relationships don’t appear clear it would be reasonable to assume that unproductive sleep exacerbates the stresses of daily life (functional capability to organize and think clearly and rationally) inducing anxiety which further affects the individual’s ability to sleep productively and that the result is a manic/ psychotic episode. The solution upon admittance to a psychiatric facility is to administer tranquilizing neuroleptics which induce sleep however the effectiveness of the sleep process remains questionable. Perhaps the drugs do not allow for a fully functional and productive sleep.

      We are encouraged that there is a real and tangible problem here; one with an organic and physical cause, as opposed to one offered up as a severe brain disease, of unknown cause, that is chronic and debilitating with little hope for recovery.

  3. kristinbell says:

    And, yes, my dad smokes cigarettes.
    No I have had many different rooms to sleep in.
    My room isn’t dark.
    I drink caffeine, because I need it to stay awake.
    I am a fussy eater who eats a lot of junk food. hehe
    I have tried melatonin and vitamins.
    It is pretty much physically impossible to wake me up after only 6 hours of sleep.
    It is complicated with the sleep, but I appreciate the advice. 🙂
    Hope you have a good day!
    🙂 kristin

  4. Mad Crone says:

    I agree completely and I have been saying this same thing for five years but no one listens to someone insane. Absolutely EVERY person I have met that is labelled schizophrenic recounts the sleeplessness prior to a psychic break. I think it is very significant that schizophrenia shows up in the teen years and that is the same time that sleep patterns change. I wrote about it on this blog (doesn’t everybody have one)

    I am currently tapering off my antipsychotic and taking melatonin whenever my sleep patterns are disrupted and so far things are good. I would have asked a psychiatrist for help in this, but when I wrote up my theory and gave it to them, they ignored it and continue to prescribe the risperdal. I am SO SURE what you are saying is correct. Stress brings on an obsession, which brings on sleeplessness or improper sleep, which brings on psychosis. The only reason neuroleptics seem to work is because they are sedating and their effectiveness is over-rated. I decided to quit asking for validation from the medical world and just decided to become my own guinea pig. Sleep is to the mind what food is for the body. “Dreaming permits each and every one of us to be quietly and safely insane every night of our lives”. -William Dement

  5. Mad Crone says:

    Me again. Quite awhile ago (2005) I wrote Mad in America writer Robert Whitaker about the sleep deprivation problems relation to schizophrenia and he sent this reply: “By the way, I’m involved in doing a documentary related to schizophrenia, and we have been interviewing people
    once diagnosed with schizophrenia, and virtually everyone had a tale about
    their descent into psychosis that involved lack of sleep.”

    Even Lindbergh had hallucinations during his long flight. I think so many schizophrenics smoke cigarettes because their bodies are dopamine starved and nicotine supplies a little.

  6. D Goldsmith says:

    REM sleep deprivation in infancy at root of psychosis
    See website

  7. I also am mad crone. I tried the melatonin thing and it was a failure. Back on risperdal and feeling fine. Also they now say I am bipolar but you know how arbitrary the labels are. Thanks.

  8. bi polar dis orders

    bi polar, bi polar disorder, bi polar dis orders, manic depression

  9. bananas says:

    My brother had schizophrenia and he had a rough time in the hospital after he was born but no one ever told me specifically what was wrong. I know I was born early but haven’t yet shown any signs of schizophrenia (I’m over 40 now so I hope that I’m mostly safe). I also have thought for years that he was dreaming while he was awake but these articles (also read articles by Claude Gottesmann and D. Goldsmith) are the first things I’ve seen that seem to validate that idea. Thank you, all for publishing your thoughts somewhere public where they can be read by those of us without connections to higher education (and the accompanying access to expensive research publications)! However, I would like to make a friendly and respectful suggestion, that you make use of Spell Check! Even though much of this terminology is not to be found already loaded in a normal spell checker, you can usually, with care, do this yourself. Also, using this will cause your texts to be taken more seriously, regardless of whether or not that is fair. You see, I am anxious for these ideas and questions to be taken seriously for the sake of those like my brother since he is now dead. Truly, thanks again.

  10. bananas says:

    Just to clarify: no one ever told me what was wrong with my brother when he was born and why he was in the hospital for awhile afterward. I found out he was schizophrenic when my mom called me — I was living out of state at the time.

    • Cheryl Prewitt says:

      Hi. My name is Cheryl. I have a 9 year old son who is seeing a phsychologist and is scheduled to begin seeing a psychyatrist in February. He began having panic attacks about 4 months ago. That is why we are seeing these doctors. The onset of the attacks was after a week long campout with the boy scouts and some dental work in which he had to be sedated. We were and really still are hoping that it has something to do with an infection that may have spread due to the infected tooth he had for a while, but among many mental disorders on my mom’s side of the family; my husband’s dad had schizophrenia. So I have been studying up on it as well. I am interested, if you are willing to share, in how your brother was as a child. Did he wet the bed for a long period of time? Did he wake up screaming in the middle of the night,but was incoherant and unable to say why and unable to remember it the next day. Those are a couple of the major things I have dealt with with my son. I am searching for all the information and answers I can get before I make any decisions on medications so any help would be greatly appreciated. Thank you. Cheryl

  11. anon says:

    Junk food and cigarettes etc. are mentioned but what about marijuana? There is already a link between marijuana use and schzophrenia and psychosis and I think marijuana is known to supress REM sleep. Maybe the loss of REM sleep is the missing link there. Please comment.

    • DREZmom says:

      My son is/was a heavy pot smoker, although he hasn’t been smoking much lately. He tired Dabs/which is all THC, wasnt sleeping and went psychotic. He did get better almost overnight after sleeping in a mental hospital. As a heavy pot smoker, I discovered that he was not dreaming. THC interfers with REM sleep.In REM sleep we process our life and our day.He is now showing signs of schizophrenia. I too believe schizophrenia is a sleep disorder. He told me last night that he hasn’t dreamed in a while. I wish more research would be done to look into this.

  12. petryan says:

    Email Via Schizophrenia Forum:

    Petrina: Your name came up on Schizophrenia Forum about the question on REM and psychosis. When I clicked on your name in blue nothing came up but your address etc.. I would like to hear what you think of the idea. I have just joined the forum and have e-mailed the editor a paper i am scheduled to give to the new york psychoanalytic which you might find fun. I’ll attach it to this. T’would be good to hear from you. Desmond Heath

  13. melody says:

    I have been working with a 35 year old gentleman for over 3 years now in a residential setting (group home) he used to be on a huge array of drugs but now is on just a few, among them clozaril. he has been complaining about having no energy forever and has periods of sleeplessness that can last for days on end with only a few hours of poor sleep between wakeful periods.
    i work overnight here and so i see what his sleeplessness does to him. the article as well as the feedback from all of you having shcizophrenia is so helpful.
    i plan on coming back often to see more insight in hopes i can better help him get through this. Peace to all and thanks for sharing! melody

  14. Ron Unger says:

    Some people who have really looked into this hypothesis in great detail are the Human Givens people in Europe. You can access an introduction to their thoughts at

  15. Desmond Heath says:

    The idea that psychosis is dreaming while awake is an old idea that seems to resurge and extinguish with a periodicity of some 50 years. Neurophysiological studies are revealing similarities between the brain in psychosis and in the REM stage if sleep. (See Hobson’s group (1994 & Sarcone 2008) and Gottesmann 2006). I have found the the clinical use of a dream breakthrough (DrBT) for diagnosing, understanding and treating psychosis in children and adolescents to be very effective in enabling adolescents to revel their closely guarded psychotic symptoms. The average duration of untreated psychosis (DUP) is two years in which the adolescent withdraws, angrily rejects parental empathic concern, often gets diagnosed with depression and then has a full psychotic break. I recommend that every initial diagnostic psychiatric interview be conducted in an open dialogue way (Seikkula 1995) with parents, sibs etc. present. This method sets up a diagnostic relationship by use of the DrBT model. The DrBT model suggests that “the human brain dreams night and day but the waking brain suppresses dreaming. But not completely for everyone; some people can be walking down the street wide awake and hear their name called.” This reframing, cognitively restructuring and partially externalizing suggestion follows upon a normalizing and demystifying description of commonly occurring psychotic-like experiences such as sleep paralysis–incidence one in three (Cheyne 1999)–and the accompanying spectral hallucination plus hypnagogic experiences as in Alice in Wonderland stories for example.DrBT model is an add on the the stress/vulnerability/coping model (Kingdon 1979, French 2004). Clinically I have found it to be readily accepted by children and adolescents, their parents and mental health care givers since I model a non-psychotophobic response along with normalizing, demystifying, partially externalizing (Epston and White 1992) and intellectualizing coping style. The DrBT approach relieves the common negative self-stigmatization by partial externalization–dreams come on us uninvited–and gives an understanding of what is happening to one.

    Cheyne, J. Allen., Newby-Clarke, Ian R., and Rueffer, Steve D., 1999 Relations among Hypnaogic and Hypnopompic Experiences Associated with Sleep Paralysis. Journal of Sleep Research. 8, 313-317

    Epston D and White. Experience, contradiction, narrative and imagination Dulwich Center Publications Adelaide Australia 1992

    Falloon RH, Fadden G. Integrated Mental health Care. Cambridge University Press 1993

    French P and Morrisson AP. Early detection and cognitive therapy for people at risk of developing psychosis: A treatment approach. (2004) John Wiley and Sons Inc. West Sussex, England.

    Gottesmann C. The dreaming sleep stage: A new neurobiological model of schizophrenia. 2006 Neuroscience

    Hobson J Allen. Chemistry of Conscious states; Dreaming as delirium: how the brain goes out of its mind. 1994 MIT Press

    Kingdon DG, Turkington D. The use of cognitive behavior therapy in a normalizing rationale in schizophrenia. J. of Nervous and Mental Disease 1979, 4 207-211

    Gottesmann C. The dreaming sleep stage: A new neurobiological model of schizophrenia. 2006 Neuroscience

    Hanssen M, Krabbendam L, De Graf R, Vollenberg W, Van Os J. Role of distress in delusion formation. Brit. J Psychiatry Aug 2005 187 Supp 48, 55-59

    Hobson J Allen. Chemistry of Conscious states; Dreaming as delirium: how the brain goes out of its mind. 1994 MIT Press

    Irwin M. Reversal of Schizophrenia Without Neuroleptics. Ethical Human Psychology and Psychiatry Vol. 6 Num. 1 Spring 2004

    Kingdon DG, Turkington D. The use of cognitive behavior therapy in a normalizing rationale in schizophrenia. J. of Nervous and Mental Disease 1979, 4 207-211

    Gottesmann C. The dreaming sleep stage: A new neurobiological model of schizophrenia. 2006 Neuroscience

    Hanssen M, Krabbendam L, De Graf R, Vollenberg W, Van Os J. Role of distress in delusion formation. Brit. J Psychiatry Aug 2005 187 Supp 48, 55-59

    Hobson J Allen. Chemistry of Conscious states; Dreaming as delirium: how the brain goes out of its mind. 1994 MIT Press

    Kingdon DG, Turkington D. The use of cognitive behavior therapy in a normalizing rationale in schizophrenia. J. of Nervous and Mental Disease 1979, 4 207-211

    Sarcone S, Manzone ML, Gambini O, Kantzas I, Limosani I,D’Agostino A and Hobson JA. The Dream as Model for Psychosis: An Experimental Approach Using Bizarreness as a Cognitive Marker. Schizophrenia Bulletin 2008 34(3):515-522

    Seikkula, J., Aaltonen, J., Alakare, B., Haarakangas, K., Keränen, J., & Sutela M. (1995). Treating psychosis by means of open dialogue. In S. Friedman (Ed.), The reflective team in action. (pp. 62-80). New York: Guilford Publication.

  16. Please see
    My theory explains that loss of REM sleep in infancy is the root of the problem, and how this occurs

  17. I read a study where 50 percent of the Schizophrenic tested had sleep apnea. I have sleep apnea. I am not Schizophrenic but I am mildly Autistic and have sleep deprivation caused migraines. I almost got tagged with Schizophrenia by the way but I don’t hallucinate. However I have my life arranged to sleep and take huge doses of tryptophan and melatonin as well as B vitamins, omega 3, avoid gluten and glutamate, etc. I think I saved myself from this fate by being smart enough to do my own research. I had a horrible time getting any one to believe me about the sleep apnea! No one could diagnose Asperger’s syndrome in the US in the 1970’s when I tried to get help in a sleep clinic as a VERY tired, frustrated teenager. Doctor could tell I was not a Neurotypical. Religious and culture differences from the Psychiatrist was also a factor. He was quite frankly a bigot! I alas was not allergic to the sleep clinic the way I was to my Mother’s Hoarding OCD mess at home and he too believed in having the family present when interviewing a teenager! So I didn’t dare mention it. If Parents are part of the problem so the Kid is then afraid to open up that is not such a good idea!

    • Desmond Heath MD says:

      Elizabeth. Sleep apnea is a major stressor on the whole system not only from loss of sleep, reduction of REM time, but eventually an accumulated loss of brain cells because of the hypoxia. This latter impairment–called something like post apnea syndrome–has been made a diagnosis and cleared for treatment with modaffinil/Nuvigil 250 mg/day. I have had sleep apnea a for 40 years, use a CPAP machine have several in different houses and recently am using–3 times only so far a new product called Provent. It is a band aide like product with a one way valve flap device that fits neatly one in each nostril. It function by letting breathed air in but slowing down out going sit there by increasing the intranasal air pressure just as the CPAP does. It takes a nit or two to get used to it. Calm down first so you are not breathing hard otherwise you will feel you are not getting enough air in through the valves. I am thinking it might replace the machines. Proven is available by prescription in the US. I think I paid $15 for 10 pairs and have used one pair twice over. Started using them for a nap not being sure of risking a whole night half awake and half asleep in apnea lucid dreaming. Bye-the-bye, I was mostly prompted to tell you that for children, even adolescents who are mad at their parents, I conduct on open dialogue, non-hierarchical family group meeting as an initial psychiatric session. I think I may be the oldest at 81years still conducting myself as Donald Winnicott did in 1954 when I spent time with him in his Paddington Green childrens’ clinic–what he called a psychoanalytic snack bar–short order cook in American parlance. I am still at it daily because by observing children who I have helped tell of their psychotic experience and helped their parents and sibs understand what they’re going through I think I am just about know what psychosis is and how schizophrenia gets to be– these along with other psychiatric disorders may be best understood as disturbances of the construction of prediction. Prediction, prediction, and prediction, like location, location and location, are the three most important things you have to know about how the human brain evolved. Read Rodolfo llinas’ book I of the Vortex. From neuron to self, and you will leap into a post llinasian world of thinking. Think of anxiety of expecting not to be able to predict, depression as a general attenuation of predictive ability, OCD as an over prediction of harm and avoidance of that harm, psychosis as an acute/chronic thalamocortical dysrhythmia disturbing perception a component on which prediction is constructed. Schizophrenia as an accumulation of mall-prediction stored in memory so distorting prediction that the person appears insane. These distortions result from a confluence of low penetrant gene variants in families vulnerable to psychosis and Sz –deficits in pre-pulse inhibition, mismatch negativity, click discrimination etc.

  18. Larson says:

    Great job. I really like your posts

  19. E Good says:

    My relative has schizophrenia and I notice that he never seems to be in a deep sleep – he’s so easily roused it’s almost like he’s never asleep. I wondered if this has anything to do with his condition — your website suggests so. Can a medication make him get REM sleep and can that help his schizophrenia???
    As a baby however, he slept 14 hours a night.

    • petryan says:

      The lack of quality sleep is what I have noticed too, when I have observed schizophrenics sleeping.
      And the psychosis usually improves after drug induced sedation.

      There is still a lot of research going on in this area.
      My website is only a platform to record observations and theories.
      In my opinion, aiding healthy sleep, and a healthy diet, will help your relative.
      Decreasing stress and avoiding illicit drugs and alcohol is also important.

  20. Kate says:

    I am curious as to who wrote this because I wanted to reference them in this paper I am writing for my child psychology class.

  21. robin says:

    I have two sons who’ve had problems since they were little. #1 son was diagnosed with Aspergers (after a few other labels) and now has been showing signs of schizophrenia. #2 son had night terrors as an infant, wet the bed until age 14 or 15, was in anger management classes in elementary school, was diagnosed with ADHD, then pronounced normal, and now I’m told is manic-aggressive. Both boys have attempted suicide. I’ve been beating myself up for years thinking I must be a horrible mom. But I began to look into family history when the schizophrenia possibility arose, and discovered that my ex husbands family (both sides) is absolutely riddled with mental illness. From schizophrenia, to depression, to agorophobia, to ADD. I learned that my ex was on Ritalin as a child as well. (No family history on my side, however I’m beginning to suspect the Aspergers may be present but undiagnosed). I also learned that sleep eludes almost all of his family, mentally ill or not. I knew my ex had sleep problems, in fact he almost shot me with his rifle while sleepwalking one night. #1 son did a little sleep walking when he was younger, and both of the boys have inconsistent sleep habits. I never could understand why because I myself am the world champion sleeper. Nobody in my family has any sleep troubles. I was laying in bed thinking about schizophrenia the other night and it came to me that I too, have illogical lines of reasoning sometimes. But only when I’m dreaming. I usualy remember my dreams and laugh at the reasoning my sleeping mind followed. I was 95% convinced that my #1 son is dreaming while he is awake. I started researching online and now I’m 100% sure. I even have paranoid dreams on occasion and believe that paranoia is a common element in dreams, just like being naked in public. That’s why schizophrenia has that common factor much of the time. These people are dreaming. Has anyone come up with the biological mechanism for waking from a dream? #2 son was anesthetized not too long ago for surgery and has been stable since then. Could there be some link with the mechanism by which anesthesia works? It has been proposed to me that mental illness causes sleep problems. I don’t believe that. Is there any hard evidence that sleep disorders come first?

    • petryan says:

      In this blog, I’ve written my ideas based on many years work in the industry. I have some ideas about why siblings of schizophrenics have a history of nightmares. I think it has something to do with the amount of stress occurring within the family environment. The siblings having nightmares are sorting through the tough family times during their dreaming at night. The potential schizophrenic however does not sleep and dream in a way that facilitates stress release.

      I have a few suggestions for stressed children who are having trouble sleeping: Avoid any chocolate after midday, avoid coca-cola after midday, avoid any other caffeinated substances after midday, if the child is still having difficulty give acetaminophen according to their age along with a multivitamin, just before bed, and spend some quiet time with them, discussing their day. Make sure all sources of light are blocked from their rooms at night (Turn their night light out *after* they fall asleep).

      If there are family dramas, seek out a good therapist for the children, someone who can help the children learn how to recognize and express the feelings they are experiencing.

    • DREZmom says:

      I concur with you 100%. Best to you…

  22. DeVin says:

    I have been schizophrenic for almost 15 yrs. I’m on a high dose of medicine called Geodon. I do not have a normal sleep schedule. I stay awake to long and I sleep to long. I wanted to share some unique things about myself. I quit smoking cigs in the middle of my illness of being a pack a day smoker for 6 yrs. Soda pop makes me vomit. I’m a pretty happy person and I don’t have nightmares. My dreams are very long and vivid. I hallucinate every second of every day with both shadows and moving colors and lights. I’ve tried some sleep pills and a lot of them don’t even work at all on me. Ambein and lunesta had no effect on me whatsoever. Some sleep aids make me hallucinate worse. I do like all kinds of foods but I prefer healthy food in the morning and sweets at night. Sometimes I over eat but not much. I have lack of exercise because I have a lot of fatigue.
    I am very happy to see that there are smart doctors investing time in helping schizophrenics. To the doctors – May your days be full of joy with out lack of any necessities that life demands.

  23. Maurice says:

    i had schizophrenia for three years. I have panic attacks and have difficulty concentrating unless i take medication. I try different techniques like million dollar point in chinese medicine and other exercises for to increase circulation and joint felxibility.

  24. M. H. says:

    FYI–I had psychosis. The prescription drugs took care of it, but a couple weeks after I left the hospital I had an interesting experience. I was dreaming and someone was talking to me in my dream then for a word or two the voice changed to the distorted low quality radio like voice I heard during my psychosis (the voice changed in the middle of a sentence) then I was awake and the voice stopped. It was like a quick transition stage from sleep to waking where the voice matched what I heard during psychosis. It has been over a year now and I have never had a similar experience. But I do personally believe psychosis is a form of the dream world especially based on my experience.

  25. Kevin F. Toon says:

    I have severe obstructive sleep apnea that never allows me to get beyond level 2 sleep (according to a sleep study I had done). Breathing is very bad and I find myself waking easily, snoring loudly, gasping, and having nightmares. The only thing that has helped me is a benzodiazapine and ambien, but the doctors only allow a certain amount. The point is, I need an awful lot of sleep but can’t get it.

    There is definitely a relationship between this and my psychosis. I feel great when I get 12-14 hours of good sleep–but this happens only about once every three months. Not good.

    Antipsychotic drugs, in my opinion, don’t seem to work especially well if you can’t sleep properly. If I could only get my sleep apnea cured, I feel that the psychosis would diminish considerably.

  26. Sherry Farrington says:

    All of this is very interesting. My husband has severe obstructive sleep apnea and has a CPAP machine but sometimes this does not help because he wakes up and pull the mask off. He has been diagnosed with schizophrenia and has been put on multiple medicines. Right now he is on the highest dose of Fanapt and taking a high dose of Effexor. He has tried several sleep medicines and anxiety medicines but has a problem with becoming addicted to those and takes too much so we have to stay away from those. He had a problem with drinking too but has stopped that for a while now. He smoked cigarettes and stopped those and after he stopped the schizophrenia got worse. He now dips tobacco. When he loses a lot of sleep like right now he goes into a psychosis again. He has finally slept a while and I am praying this helps the psychotic episode!! I wish more psychiatrists would investiage all of this information more because they do not want to even discuss sleep problems. My husband’s doctor told him not to worry if he had periods of not sleeping well. Mental illness is so very hard and nobody understands until they have gone through it themselves or a family member has. I am going to try to get my husband to take some of the vitamins I have seen listed. Thanks so much!!
    Best of luck to you all!!

  27. spikel14 says:

    This is absolutely fascinating and my instinct tells me you’ve got it 100% right. Only time will tell for sure, it’s a shame this has no publicity… I’ve also heard of schizophrenic people coming back to normal after taking Ambien. This also happened to a guy in a coma, but it only lasts as long as the drug lasts, and like benzos, can never be a long term solution.

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  33. vincent zetta says:

    I have two schizophrenic sons. I am currently experiencing the sleeping phenomenon that is described – I enter into partial REM. I have PTSD due to an extremely traumatic event in my life. My anxiety is off the charts. This event I have thought may have activated either bipolar of schizophrenia. This partial REM sleep, it feels like part of my brain is always conscious even while sleeping. It is killing me. Please refer to me a psychiatrist in Colorado that knows what he is doing.

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