The Effects Of Hyperbaric Oxygen On Sleep Disorders In Overweight Schizophrenics

Objective To investigate the effects of hyperbaric oxygen?HBO?on sleep disorders in patients with overweight schizophrenia and to analyze relation between levels of docosahexaenoic acid?DHA?,superoxide dismutase?SOD?and sleep disorders Methods We collected a group of 40 male patients with schizophrenia met the DSM-?diagnostic criteria and overweight standard established by the National Health and Family Planning commission of China in 2013?BMI?24kg/m2?,The subjects was divided into two groups:one group was treated by HBO combined with atypical antipsychotic drugs?HBO?,the other group was only treated by atypical antipsychotics?Control??25 people in HBO group,including 5 first-episode schizophrenia patients and 20 chronic schizophrenic patients;15 Controls,including 6 first-episode schizophrenic patients and 9 chronic schizophrenic patients?;and all patients in the group used one or more of the combined drugs of atypical antipsychotics.Positive and Negative Syndrome Scale?PANSS?was used to before the treatment and at the end of6^th weeks of treatment.HBO group was treated with HBO once a day?pure oxygen for2 hours under 2 Atmosphere Absolute?,10 times,2 days at intervals after each course,and a total of three courses.The Pittsburgh sleep quality index?PSQI?was used to evaluate sleep disorder and collect blood samples were collected at the weekend of 2^nd,4 ^th and 6 ^th before and after HBO treatment.Polysomnography?PSG?was performed before and at the end of the 6^thh week of treatment;The levels of plasma DHA and SOD in the two groups were measured by enzyme-linked immunosorbent assay and spectrophotometer experiments before HBO“pre-treatment”,“treatment for 2 weeks”,“treatment for 4 weeks”,and“treatment for 6 weeks”.Results:?1?The total scores,scores of PANSS scale and PSQI scale before treatment in the two groups were tested for normality.The total score of PANSS between the two groups was not statistically significant before treatment?P>0.05?.The PSQI scale showed that the differences of C3,C4,C6 and total scores between the two groups before treatment were statistically significant?P<0.05?.?2?The PANSS scores of patients in the two groups were compared before and after the“pre-treatment”and“treatment for 6weeks”.The PANSS scores,positive symptoms,negative symptoms and general pathological features of the two groups were found before and after treatment were statistically significant?P<0.05?.The total scores of PANSS between the two groups before and after the“pre-treatment”and“treatment for 6 weeks”were compared,and the results showed no statistical significance?P>0.05?.?3?There were significant differences between the two groups in the PSQIC1,PSQIC4,PSQIC5,and PSQIC6scores at different time points?P<0.05?,and there were statistically significant differences in pairwise comparison of PSQIC1,PSQIC4,PSQIC5 and PSQIC6 scores between the two groups at different time points?P<0.05?.There were significant differences in the total scores of PSQI between the two groups at different time points?P<0.05?.There were statistical differences between the two groups except PSQIC1?P<0.05?.?4?Baseline comparison of pre-treatment data of PSG data between the two groups before treatment showed that there was no significant difference at baseline?P>0.05?.The PSG indicators of the two groups were compared before and after the“pre-treatment”and“treatment for 6 weeks”.The results showed that the differences of a sleep latency,total sleep time,sleep efficiency,NREM sleep duration,and slow wave sleep?Slow-Wave Sleep,SWS?in the HBO group between the two time points were statistically significant?P<0.05?;the results of PSG between the two groups of patients treated at the weekend of 6 ^th were compared?normal data were obtained for an independent sample t-test,otherwise nonparametric test was performed?,found that the difference of“SWS sleep duration”,“stage 3 sleep efficiency”and“sleep apnea hypopnea index AHI?Apnea–Hypopnea Inde,AHI?”between the two groups of patients was statistically significant?P<0.05?,and the differences of the others were not significantly different between the groups treated at the weekend of 6 ^th?P>0.05?.?5?In the“pre-treatment”and“treatment for 6 weeks”,the sleep latency,total sleep time,and sleep efficiency of PSQI and PSG were compared within the two groups.The results showed that there were significant differences between the HBO group's“pre-treatment total sleep time”and“sleep-sleeping latency treated at the weekend of 6 ^th”?P<0.05?.The difference between PSG and PSQI of the patients in control group on the project of“pre-treatment sleep-sleeping latency”and“before treatment”was statistically significant?P<0.05?,and the other groups were not statistically significant?P>0.05?.There was a correlation between PSG and PSQI in the HBO group on the"pre-treatment sleep efficiency"item?Pr<0.05,r=0.407?.?6?The plasma DHA and SOD levels of the two groups were compared before treatment.The results showed that the baseline level was not significantly different;The changes of plasma DHA?SOD levels at each time points were compared in the two groups respectively.The results showed that the plasma SOD levels in the HBO group were significantly different between“treatment for 2 weeks”,and“treatment for 6 weeks”?P<0.05?,and there was a positive linear correlation between“plasma DHA level change”and“total sleep time change”?P<0.05?;The difference of plasma DHA before and after“pre-treatment and treatment for 2 weeks”,“pre-treatment and treatment for 6 weeks”,and“treatment for2 weeks and treatment for 6 weeks”in HBO group was correlated with the difference of SOD corresponding time point,moreover,between the difference of DHA and the difference of SOD at the time points of“pre-treatment and treatment for 6 weeks”and“treatment for 2 weeks and treatment for 6 weeks”showed a positive correlation?P<0.05?.Conclusion:?1?DHA is associated with elevated SOD levels and long sleep duration in men with overweight schizophrenia.?2?HBO treatment may play a role in improving SOD level of patients;?3?HBO treatment may play a certain role in patients'sleep latency,sleep efficiency,NREM sleep duration,SWS sleep duration,phase 3 sleep efficiency,and AHI improvement;?4?Patients with schizophrenia may have different primary and objective evaluations of their own sleep,and we need to pay attention to the evaluation of patients'sleep.