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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Front+Psychiatry
2018 ; 9
(ä): 303
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Severe Sleep Deprivation Causes Hallucinations and a Gradual Progression Toward
Psychosis With Increasing Time Awake
#MMPMID30042701
Waters F
; Chiu V
; Atkinson A
; Blom JD
Front Psychiatry
2018[]; 9
(ä): 303
PMID30042701
show ga
Background: Going without sleep for long periods of time can produce a range of
experiences, including perceptual distortions and hallucinations. Many questions,
however, remain unanswered regarding the types of symptoms which are most
reliably elicited, the time of symptom onset, and whether symptoms worsen over
time toward psychotic decompensation. Since sleep deprivation exceeding 48 h is
considered unethical today, an examination of historical studies with extreme
sleep-loss duration is needed to obtain information about what happens during
prolonged sleep loss. Methods: A systematic-review approach was used to identify
experimental and observational studies of sleep deprivation in healthy people
which describe the effects of prolonged sleep loss on psychopathological
symptoms, without any date restriction. Results: A total of 476 articles were
identified. Of these, 21 were eligible for inclusion. Duration of sleep loss
ranged between 24 h and 11 nights (total 760 participants; average 72-92 h
without sleep). All studies except one reported perceptual changes, including
visual distortions (i.e., metamorphopsias), illusions, somatosensory changes and,
in some cases, frank hallucinations. The visual modality was the most
consistently affected (in 90% of the studies), followed by the somatosensory
(52%) and auditory (33%) modalities. Symptoms rapidly developed after one night
without sleep, progressing in an almost fixed time-dependent way. Perceptual
distortions, anxiety, irritability, depersonalization, and temporal
disorientation started within 24-48 h of sleep loss, followed by complex
hallucinations and disordered thinking after 48-90 h, and delusions after 72 h,
after which time the clinical picture resembled that of acute psychosis or toxic
delirium. By the third day without sleep, hallucinations in all three sensory
modalities were reported. A period of normal sleep served to resolve psychotic
symptoms in many-although not all-cases. Conclusions: Psychotic symptoms develop
with increasing time awake, from simple visual/somatosensory misperceptions to
hallucinations and delusions, ending in a condition resembling acute psychosis.
These experiences are likely to resolve after a period of sleep, although more
information is required to identify factors which can contribute to the
prevention of persistent symptoms.