Studien ämnade att undersöka skillnader mellan olika klientgrupper i behandlingseffekt med avseende på ångest, depression, utbrändhet, sömn och stress efter deltagande i stress- eller sömnskola. Detta undersöktes genom att studera om bakgrundsfaktorer såsom sökorsak, tidigare behandling, hälsostatus före behandling samt demografiska faktorer har betydelse för behandlingseffekten. Stress- och sömnskolorna är manualbaserade gruppbehandlingar riktade mot antingen stressproblematik eller sömnproblematik som genomfördes inom primärvården av psykologstudenter under handledning av legitimerad psykolog. Skolorna baseras på kognitiv beteendeterapeutisk metod (KBT) och består av fyra träffar. Studien baseras på data från 95 personer som genomförde behandlingen samt deltog i för- och eftermätning. För att undersöka sambandet mellan bakgrundsvariabler och behandlingsutfall genomfördes i ett första steg bivariata korrelationsanalyser. Baserat på de signifikanta sambanden utfördes därefter regressionsanalyser för att undersöka bakgrundvariablernas prediktiva inverkan på behandlingsutfallet. Resultatet visade att få bakgrundsvariabler kunde predicera utfallet vilket indikerar att behandlingen är effektiv för en bred grupp av patienter. De variabler som kunde predicera behandlingsutfall med avseende på insomni respektive utbrändhet var att man hade angivit utbrändhet respektive insomni som sökorsak. Detta dubbelriktade samband mellan utbrändhet och insomni har även visats i andra studier. Studiens resultat ger stöd för att behandlingen har en kliniskt relevant effekt för en bred grupp av patienter, men den ger också en indikation på att de som sökt för utbrändhet- och/eller sömnproblematik kan behöva fler och längre insatser. / The study aimed to investigate differences between client groups in treatment effect with respect to anxiety, depression, burnout, sleep and stress after participating in stress or sleep group treatment. This was investigated by studying whether background factors such as reason for seeking medical treatment, previous treatment, health status before treatment and demographic factors are related to the treatment effect. The stress- and sleep group treatments are psychoeducative, manual-based, aimed at stress or sleep problems. The treatments were implemented in a primary care setting by psychology students under the supervision of a licensed psychologist. The group treatments are based on the cognitive behavioral therapy method (CBT) and consist of four meetings. The study is based on data from 95 individuals who completed the treatment and participated in pre- and post-measurements. To investigate the relationship between background variables and treatment outcome, bivariate correlation analyzes were performed in a first step. Based on the significant correlations, regression analyzes were then performed to examine the predictive effects of the background variables on the treatment outcome. The results showed that few background variables could predict the outcome, which indicates that the treatment is effective for a broad group of patients. The variables that could predict treatment outcomes with regard to insomnia and burnout, respectively, were that burnout and insomnia had been stated as the reason for seeking medical treatment. This two-way link between burnout and insomnia has also been shown in other studies. The results of the study provide support that the treatment has a clinically relevant effect for a broad group of patients, but it also gives an indication that those seeking treatment for burnout and/or insomnia may need additional and longer interventions.

Objective: To determine the feasibility of an online cognitive behavioral therapy for insomnia (CBT-I) in bereaved older adults. Participants: The study participants include adults aged 55 and older (N = 30) that lost a loved one within the past five years and are currently experiencing symptoms of insomnia. Methods: This study used an experimental design and was guided by the Transitions Theory developed by Meleis. Descriptive statistics and t-tests were used to measure changes within and between groups. Experimental arm had the CBT-I online treatment and the control arm had attention controlled online tasks. Intervention fidelity was measured. Results: The online CBT-I intervention is a feasible intervention for bereaved older adults with insomnia. High retention rates were shown in both groups, and both groups’ insomnia and mood symptoms improved at post- study measurement. There were no statistically significant differences seen in any measure between groups. Conclusions: Transitions in older adult life includes loss of friends and family as well as development of sleep issues. The Transitions Theory is useful for informing the design of behavioral interventions in this older population. Further research is needed to understand how sleep can be improved by cost effective online interventions that might not include solely CBT-I.

No description available.

La population âgée est vulnérable face à des problèmes d’insomnie qui peuvent parfois être accompagnés d’anxiété. La thérapie cognitivo-comportementale pour insomnie (TCCi) est le traitement de première ligne pour l’insomnie mais reste peu accessible. Le développement d’une TCC pour l’insomnie et l’anxiété délivrée sur la plateforme en ligne e-SPACE fournit l’accessibilité d’une intervention novatrice pour les personnes âgées isolées. Les objectifs étaient : 1) d’évaluer la convivialité et l’acceptabilité de e-SPACE 2) vérifier l’efficacité de la TCC en ligne pour l’insomnie et l’anxiété. Ainsi, 92 participants âgés insomniaques répartis aléatoirement dans deux groupes (groupe 1 TCCi en ligne N = 47 et groupe 2 liste d’attente N = 45) ont complété : - Agenda de sommeil, Index de Sévérité de l’Insomnie (ISI) et Inventaire d’anxiété gériatrique (GAI) avant et après thérapie/attente pour vérifier l’efficacité - Questionnaire de satisfaction adapté de l’échelle de mesure de la convivialité (SUS) et du questionnaire du modèle d’acceptation technologique 2 (TAM-2), pour vérifier la convivialité et l’acceptabilité La moyenne de score SUS indique que la plateforme e-SPACE est conviviale. Les questions du TAM-2 confirment que son acceptabilité repose sur sa facilité d’utilisation, son utilité et la démontrabilité des résultats. La diminution significative des scores ISI (F = 19.855, p < 0.001) et GAI (F = 11.332, p = 0.001) uniquement chez le groupe 1 démontre l’efficacité de la thérapie. Cependant, il reste une marge d’amélioration afin que la plateforme soit plus adaptée et plus efficace à traiter les symptômes d’insomnie et d’anxiété pour les aînés. / The elderly population is vulnerable to insomnia problems that can sometimes come along with anxiety. Cognitive-behavioural therapy for insomnia (CBTi) is considered as the first-line treatment for insomnia but is still not widely available. The development of an internet-delivered CBT for insomnia and anxiety on the e-SPACE online platform provides accessibility to an innovative intervention for isolated seniors. The objectives were : 1) to assess the usability and acceptability of e-SPACE 2) to verify the efficacy of the online CBT for insomnia and anxiety. Thereby, 92 elderly participants with insomnia were randomised into two groups (group 1 online CBTi N = 47 and group 2 waiting list N = 45) and completed : - Sleep Diary, Insomnia Severity Index (ISI) and Geriatric Anxiety Inventory (GAI) before and after therapy/waiting to verify efficacy - Satisfaction questionnaire adapted from the System Usability Scale (SUS) and the extension of Technology Acceptance Model (TAM-2) to verify usability and acceptability The means of SUS score indicates that the e-SPACE platform is user-friendly. The TAM-2 questions confirm its acceptability is predominantly based on perceived ease of use, perceived usefulness and the result demonstrability. The significant decrease of ISI (F = 19.855, p < 0.001) and GAI (F = 11.332, p = 0.001) scores in group 1 alone confirms the effectiveness of the therapy. However, there is room for improvement so that the platform is more suitable and more effective in treating the symptoms of insomnia and anxiety for seniors.

To be able to sleep is vital for our existence. During the process of falling asleep, many people are struggling and as an outcome, various mental health problems and sleep disorders are occurring among them. Previous studies are blaming the spreading health problems on the smartphone users for bringing their phone into their bedroom. Simultaneously, studies are showing that nocturnal smartphone usage is extremely common, with a huge spike in use during nighttime. Also, findings in studies with a different area of focus are showing that people suffering from sleep difficulties and insomnia benefits from visual stimulation and focused attention during sleep onset. This study aims to find beneficial smartphone interactions for people who are currently experiencing sleep problems. By gathering information from literature and previous studies done in the fields of insomnia, mental health problems, smartphone usage, human-computer interaction and sleep in general, the theoretical foundation of this study is laid out. To verify the previous findings and find out more about nocturnal smartphone usage, interviews and exercises with both subjective good and bad sleepers are performed. Ideas are generated and extracted through a workshop together with the collaboration partners. Visualization of the possible solution is made as a hi-fi prototype, which is later tested upon the target group of bad sleepers for three nights. In combination, the solution concept is tested together with a secondary concept through the Wizard of Oz method. The evaluation of the concepts is collected as an online form through their smartphones and the feedback from the participants is leading to a final design suggestion. This study is presenting solutions for designing for nocturnal usage, which through this study has been proven decreasing the subjective sleep onset latency among the users and in the long run will improve the user's digital well being.

本研究嘗試檢視原發性失眠 (Primary insomnia) 患者在接受完認知行為治療後，其生理激發系統與恆定系統相關生理指標的改變，並探討其主、客觀睡眠改善與生理指標變化之間的關聯，藉以瞭解不同的生理系統在影響原發性失眠患者其主、客觀睡眠改善程度上可能的重要性。本研究透過醫師轉介，共18名原發性失眠患者 (男5人，女13人，平均年齡37.4歲) 接受7週6次的失眠認知行為治療，在接受治療的前後，分別進行一個晚上的多頻道睡眠記錄檢查與主、客觀睡眠評估。再進一步分析高頻率腦波Beta波 (14~35Hz) ，用來反應其中樞神經系統的激發，低頻率腦波Delta波 (0.5~2.5Hz) 則用來反應個案的恆定系統；另外，透過心跳變異率分析得出的參數，包括低頻率 (Low frequency，簡稱LF) 功率與高頻率 (High frequency，簡稱HF) 功率，以LF/HF的比率值測量其交感神經系統的活動，而HF/ (LF+HF) 則是測量副交感神經系統的活動。研究結果顯示個案的失眠問題在主觀睡眠評估指標上有顯著改善，而客觀睡眠評估指標與睡眠結構於入睡時間與入睡後清醒時間有顯著降低，其餘則無顯著改善。而各項生理系統指標，僅後半夜階段二的腦波的Delta波有顯著上升，其餘均無顯著地改善，而LF/HF的下降與失眠嚴重度的下降有顯著地關聯。因此，本研究顯示原發性失眠患者接受認知行為治療前後，其交感神經系統的下降與失眠嚴重度之改善有明顯關聯，推論失眠認知行為治療對於原發性失眠患者的交感神經活動的改善，可能是使其失眠嚴重度改善的關鍵。 / The present study evaluated the changes in beta and delta ranges of electroencephalogram (EEG) power and heart rate variability (HRV) after cognitive behavioural therapy for insomnia (CBT-I) to understand the effect of CBT-I on arousal system and homeostatic system. The study also examined the correlations between change of sleep measurement and the physiological index to clarify underlying mechanisms of sleep improved by CBT-I. Eighteen primary insomnia patients (5 males, 13 female, mean age = 37.4) participated in this study. The participants were scheduled to come to the sleep laboratory for polysomnographic (PSG) recording twice, one prior to CBT-I and one following CBT-I. A course of 6-session CBT-I was conducted during a period of seven weeks. Subjects’ changes in subjective ratings of sleep quality and quantity and sleep parameters in PSG were calculated. Spectrum analyses were conducted for their EEG and electrocardiogram (EKG). Beta EEG activity (14~35 Hz) was used to indicate the central nervos system (CNS) arousal level and Delta EEG activity (0.5~2.5 Hz) for the intensity of homeostatic system. Low frequency power (LF) and high frequency power (HF) of the R-R interval were calculated for heart rate variability (HRV). LF/HF ratio was used as a index of sympathetic nervous system activity and the HF/ (LF+HF) ratio as a index of parasympathetic nervous system activity. The results show subjective sleep quality of subjects were significantly improved after CBT-I. PSG shows shortened sleep onset latency and decreased wake time after sleep onset, but not in the other measures. For EEG spectrum and HRV parameters, only Delta EEG activity in stage2 of the second half of the night was significantly improved. In addition, the decrease of LF/HF significantly correlated with the improvement of the insomnia severity index. Thus, the results suggests that sleep improvements by CBT-I may be associated with the reduction of sympathetic arousal.

No description available.

Prionkrankheiten sind übertragbare, tödliche neurodegenerative Erkrankungen beim Menschen und bei Tieren. Sie basieren auf der Konversion des zellulären Prion-Proteins (PrPC) in seine pathogene Form (PrPSc). Durch diese Konversion sind Prionkrankheiten pathogen und übertragbar. Bis heute ist weder der dem zugrunde liegende Mechanismus verstanden noch eine Behandlung gefunden worden. Die sichere Diagnose einer sporadischen Prionkrankheit ist ausschließlich mittels Gehirnbiopsie möglich, weswegen zu Lebzeiten des Patienten häufig nur die Diagnose einer wahrscheinlichen Prionkrankheit erfolgt. Zusammen mit der klinischen Heterogenität der Prionkrankheiten weisen neueste Erkenntnisse auf das Vorhandensein mehrerer humaner Prionstämme hin. Für die Suche nach Medikamenten fehlt ein geeigneter Wirkstoff-Suchtest, der auf der humanen Pathogenese basiert, für einen hohen Durchsatz geeignet und gut reproduzierbar ist. Die real-time quaking-induced conversion (RT-QuIC), eine neu entwickelte in vitro-Methode, erlaubt den Nachweis von bisher nicht messbaren Mengen an PrPSc in humanem Liquor cerebrospinalis (Liquor). Dazu werden die selbst-replizierenden Eigenschaften des PrPSc genutzt. Erste Untersuchungen weisen auf distinkte Eigenschaften humaner Prionkrankheiten in der RT-QuIC hin. Zum Einsatz in Diagnostik und Forschung bedarf es jedoch einer umfassenden Validierung der Methode für die Anwendung mit humanem Liquor. In dieser Arbeit beträgt die Sensitivität der RT-QuIC 85,5 % und die Spezifität 99,5 % für humane Prionkrankheiten. Die Reproduzierbarkeit im Ringversuch ist gut bis exzellent. Die Kurzzeitlagerungen der Liquorproben bei Raumtemperatur und +4°C sowie die Langzeitlagerung bei −80°C und das wiederholte Einfrieren und Auftauen haben keinen Einfluss auf die Testergebnisse. Jedoch führt die Kontamination mit Blut zu falsch-negativen Resultaten. Diese Ergebnisse weisen auf eine Eignung der RT-QuIC zur sicheren Diagnose von Prionkrankheiten zu Lebzeiten der Patienten hin. Zur Charakterisierung des Reaktionspotentials möglicher humaner Prionstämme wurden Liquorproben von verschiedenen humanen Prionkrankheiten wie bspw. der sporadischen und der genetischen Form mittels RT-QuIC untersucht. Die Auswertung der Daten zeigt distinkte Eigenschaften des PrPSc im Liquor, die moduliert werden durch die Form der Prionkrankheit, den Prnp Codon 129-Genotyp und die Krankheitsdauer. Diese Ergebnisse zeigen das Potential der RT-QuIC, die selbst-replizierenden Eigenschaften des PrPSc im Liquor zu untersuchen, womit erstmals eine Methode zur Verfügung steht, um diese Effekte in Patienten während der symptomatischen Phase zu studieren. Zur Nutzung der RT-QuIC als neuartige Methode zur Wirkstoffsuche wurde die Wirkung mehrerer Stoffe auf die RT-QuIC-Reaktion untersucht. Doxyzyklin inhibiert diese Reaktion sowohl in Korrelation mit der Dosis als auch mit dem Zeitpunkt der Zugabe. Diese Ergebnisse weisen auf eine Eignung der RT-QuIC zur Suche von Stoffen hin, die den PrP-Konversionsprozess inhibieren und zeigen die inhibierende Wirkung von Doxyzyklin auf die in-vitro-Amplifikation von PrPSc.

研究目的 失眠的過度激發是目前最廣為接受的失眠病因之一。無論在生理、認知、行為三不同層面上，多可觀察到失眠者有身心過度激發的狀態。根據失眠三因子模式，不同失眠病程階段，影響過度激發的背後成因有所差異。在慢性失眠部分，過 去累積了相當多的實證研究證實其過度激發的現象，但尚未進入慢性病程前之過度激發相關機轉，仍有待研究進一步探討。本研究嘗試以橫斷式的研究方法，並依據過去失眠病因發展推導，選擇從壓力反應特性 (包含壓力操弄後的壓力反應強度和 消退速度)、注意力偏誤 (包含警覺性注意力和注意力移除困難)、與睡前的睡眠監控行為三個面向切入，探討不同病程階段個體過度激發的背後機轉，並進一步檢驗上述之差異是否可用以預測在壓力操弄情境下，不同病程個體睡前的激發反應變化，藉此檢驗失眠病程發展之病因假說，並希望未來可據此發展有效之失眠防治與介入策略。 研究方法 本研究共計招募受試者 58 人，年齡介於 24-48 歲，包含符合 ICSD-3 慢性失眠者 18 人，以及以壓力下失眠反應量表( Ford Insomnia Response to Stress Test; FIRST)區分出急性失眠高危險組 19 人與低危險組 21 人。每位受試者皆需到睡眠實驗室進行兩階段的實驗，第一階段包含晤談評估、問卷填答、壓力反應的生理測量(以指溫與膚電為指標)、與包含威脅與睡眠刺激之點偵測注意力作業，之後需配戴腕錶與記錄睡眠日誌配合充足且規律作息一週後，再到睡眠實驗室進行第二階段的評量，包含睡前 2 小時、1 小時、關燈前生理指標 (指溫、膚電) 與腦波的測量和主觀身心激發狀態 (Pre-Sleep Arousal Scale, 簡稱 PSAS) 評量，於睡前填寫睡眠相關監測指標 (Sleep Associated Monitoring Index，簡稱 SAMI)，並完成一晚的 PSG 測量以排除其他睡眠相關疾患。 研究結果 首先，以單因子變異數分析比較不同組別間在壓力反應與回復和二因子變異數分析注意力警覺/移除困難指標的差異。在壓力生理反應表現上，慢性失眠組與高危險組在接受壓力操弄後的激發消退時間較低危險組來得長。在注意力層面，高危險組對壓力(威脅圖片) 刺激有顯著的警覺與移除困難注意力偏誤，慢性失眠組則是對睡眠刺激有顯著的移除困難注意力偏誤。在行為層面，慢性失眠組與高危險組睡前的注意力監控行為 (包含監測自身身體感覺訊息是否與入睡狀態不一致、鬧鐘 時間、環境) 均顯著較低危險組來得多。再者，以皮爾森相關探討注意力偏誤與睡前激發反應之關聯性，結果顯示高危險組的注意力偏誤現象與睡前高頻腦波與主觀生理激發的降幅呈現顯著負相關; 而慢性失眠組的注意力偏誤指標卻與膚電、主觀認知激發的降幅呈顯著正相關。 結論 本研究結果支持不同失眠病程背後的過度激發影響機制有所差異，生理層面較慢的激發消退能力與對壓力源的認知偏誤的前置因子，可能為急性失眠者易受日常壓力源誘發睡眠困擾之原因；而影響慢性失眠族群的持續因子主要在於其將睡眠視 為壓力源的認知歷程與行為轉變。此外，研究更進一步發現兩組分別對於壓力與睡眠的注意力轉移困難，使其在覺察壓力後易持續表現出過度激發現象。本研究結果除支持失眠過度激發理論之外，更釐清不同階段失眠的認知歷程的機制，並彰顯不 同失眠病程介入策略應有所差異，和急性失眠高危險族群及早介入預防之重要性。 / Introduction Hyperarousal has been recognized to be a major etiological factor of chronic insomnia. Cumulated research evidences have demonstrated that chronic insomnia patients are hyperaroused in somatic, cognitive, and behavioral aspects. According to Spielman’s 3P Model of Insomnia, there were different factors are involved at different points during the course of insomnia. However, there are seldom study to investigate the difference mechanism of hyperarousal in the course of the development of insomnia. The present study used cross-sectional design to compare the difference of good sleeper (low sleep vulnerability, LV), acute insomnia (high sleep vulnerability, HV), and chronic insomnia (CI) in stress reaction (eg. reactivity and recovery), attentional bias (eg. vigilance and disengagement), and sleep associated monitoring behaviors to investigate the underlying mechanism of hyperarousal. Furthermore, the study examined the correlation between attentional bias indices and subsequent pre-sleep arousal to investigate the impact of attentional bias on sleep in different groups. Method The present study recruited fifty-eight subjects, aged between 24-48. They included eighteen chronic insomniacs (CI) diagnosed ICSD-3, nineteen healthy individuals scoring high (HV) and twenty-one healthy individuals scoring low (LV) on the Ford Insomnia Response to Stress Test (FIRST). All subjects visited sleep lab twice. During the first visit, the subjects filled in a package of questionnaires, and went through psychophysiological recording (including) of stress reaction, and a visual dot-probe task. They then were required to keep a sleep log and wear actigraphy at home for one-week to make sure they followed a regular sleep schedule. During the second visit, subjects went through a pre-sleep physiological recording (including peripheral temperature, skin conductance, and EEG) and filled in two questionnaires (Pre Sleep Arousal Scale [PSAS] and Sleep Associated Monitoring Index[SAMI]) at three time points and had a PSG recording to screen for sleep disorders. Result One-way ANOVAs were conducted to compare the differences of stress reaction/recovery among three groups. Two-way ANOVAs were used to compare the differences in attentional bias (vigilance/ disengagement) of threatening and sleep-related stimulus among three groups. In stress related physiological activity, CI and HV showed slower recovery rate than LV. Considering attentional bias, HV had significant vigilance and disengagement bias to threatening pictures, and CI had significant disengagement bias to sleep-related pictures. CI and HV also showed more prevalent sleep-associated monitoring behaviors than LV. Furthermore, Spearman’s correlation was used to examine the association between attentional bias and pre-sleep arousal. The result shows the attentional bias of HV had negative correlation with reduction of high frequency EEG and somatic sub-score on the PSAS. In contrast to our prediction, CI showed positive correlation between decrease of skin conductance and the cognitive sub-score on the PSAS. Conclusion The study showed that stress recovery ability and stress-related attentional bias were the major differences between individuals with low and high sleep vulnerability, indicating that increased information processing to threats and stress-related stimulus as well as decreased recovery ability of autonomic arousal in reacting to stress may predisposed an individual to stress-related sleep disturbances. On the other hand, the attention shift from threat toward sleep can differentiate chronic insomnia from those individual with frequent acute insomnia. Moreover, the difficulty in disengagement from sleep-related stimulus, rather the vigilance, might explain the cause of hyperarousal that perpetuate insomnia. The results support the transition of arousal from general treat to sleep-related stimulus in the development of chronic insomnia. The study not only further the understanding of the etiological mechanism of insomnia, but also imply that different strategies should be applied in the treatment of acute and chronic insomnia. It also highlights the importance of preventive intervention for individuals with high sleep vulnerability

Les personnes atteintes de schizophrénie peuvent présenter un sommeil anormal même lorsqu’elles sont stables cliniquement sous traitements pharmacologiques. Les études présentées dans cette thèse ont pour but de mesurer le sommeil afin de mieux comprendre les dysfonctions des mécanismes cérébraux pouvant être impliqués dans la physiopathologie de la schizophrénie. Les trois études présentées dans cette thèse rapportent des résultats sur le sommeil dans la schizophrénie à trois niveaux d’analyse chez trois groupes différents de patients. Le premier niveau est subjectif et décrit le sommeil à l’aide d’un questionnaire administré chez des personnes atteintes de schizophrénie cliniquement stables sous traitements pharmacologiques. Le deuxième niveau est objectif et évalue le sommeil par une méta-analyse des études polysomnographiques chez des patients atteints de schizophrénie ne recevant pas de traitement pharmacologique. Le troisième niveau est micro-structurel et utilise l’analyse spectrale de l’électroencéphalogramme (EEG) afin de caractériser le sommeil paradoxal de patients en premier épisode aigu de schizophrénie avant le début du traitement pharmacologique. La première étude montre que, lorsqu’évaluées par un questionnaire de sommeil, les personnes atteintes de schizophrénie cliniquement stables sous traitements pharmacologiques rapportent prendre plus de temps à s’endormir, se coucher plus tôt et se lever plus tard, passer plus de temps au lit et faire plus de siestes comparativement aux participants sains. Aussi, tout comme les participants sains, les personnes atteintes de schizophrénie rapportent un nombre normal d’éveils nocturnes, se disent normalement satisfaites de leur sommeil et se sentent normalement reposées au réveil. La deuxième étude révèle qu’objectivement, lorsque les études polysomnographiques effectuées chez des patients non traités sont soumises à une méta-analyse, les personnes atteintes de schizophrénie montrent une augmentation du délai d’endormissement, une diminution du temps total en sommeil, une diminution de l’efficacité du sommeil et une augmentation de la durée des éveils nocturnes comparativement aux participants sains. Les patients en arrêt aigu de traitement ont des désordres plus sévères au niveau de ces variables que les patients jamais traités. Seulement les patients jamais traités ont une diminution du pourcentage de stade 2 comparativement aux participants sains. La méta-analyse ne révèle pas de différence significative entre les groupes en ce qui concerne le sommeil lent profond et le sommeil paradoxal. La troisième étude, portant sur l’analyse spectrale de l’EEG en sommeil paradoxal, montre une diminution de l’amplitude relative de la bande de fréquence alpha dans les régions frontales, centrales et temporales et montre une augmentation de l’amplitude relative de la bande de fréquence bêta2 dans la région occipitale chez les personnes en premier épisode de schizophrénie jamais traitées comparativement aux participants sains. L’activité alpha absolue est positivement corrélée aux symptômes négatifs dans les régions frontales, centrales et temporales et négativement corrélée aux symptômes positifs dans la région occipitale. L’activité beta2 absolue ne montre pas de corrélation significative avec les symptômes positifs et négatifs de la schizophrénie. Ces résultats sont discutés suivant la possibilité que des dysfonctions au niveau des mécanismes de la vigilance seraient impliquées dans la physiopathologie de la schizophrénie. / Patients with schizophrenia may have an abnormal sleep even when clinically stable under pharmacological treatments. In the present thesis, sleep studies aim at measuring central nervous system dysfunctions that can be involved in the pathophysiology of schizophrenia. The present thesis includes three studies. These studies report results on sleep in patients with schizophrenia in a three levels analysis with three different groups of patients. The first level is subjective and describes sleep habits using a questionnaire administered to outpatients with schizophrenia clinically stable under pharmacological treatments. The second level of analysis is objective and evaluates sleep architecture using a meta-analysis of polysomnographic studies in untreated patients with schizophrenia. The third level is microstructural and uses electroencephalogram (EEG) spectral analysis to characterize REM sleep in never-treated patients with first-episode schizophrenia. The first study shows that, when evaluated using a sleep habits questionnaire, outpatients with schizophrenia clinically stable under pharmacological treatments report increased time to fall asleep, have earlier bedtime, later risetime, spend more time in bed and do more naps compared to healthy participants. Also, similarly to healthy participants, most patients with schizophrenia report normal wake time after sleep onset, are normally satisfied about their sleep and feel normally refreshed in the morning. The second study reveals that, objectively, when polysomnographic studies evaluating untreated patients with schizophrenia are submitted to a meta-analysis, patients with schizophrenia have increased sleep latency, reduced total sleep time, reduced sleep efficiency and increased wake time after sleep onset compared to healthy participants. Patients in acute drug withdrawal show more severe sleep disturbances in these variables compared to never treated patients. Only never treated patients show decreased stage 2 sleep duration compared to healthy participants. The meta-analysis does not reveal significant differences between groups in regards to slow wave sleep and paradoxical sleep variables. The third study about REM sleep EEG spectral analysis shows decreased relative alpha spectral amplitude in frontal, central and temporal cortical regions and increased relative beta2 spectral amplitude in the occipital region in never treated patients with first-episode schizophrenia compared to healthy participants. Absolute alpha spectral amplitude correlates positively with negative symptoms in the frontal, central and temporal regions and negatively with positive symptoms in the occipital region. No significant correlation has been observed between beta2 spectral amplitude and clinical symptoms of schizophrenia. These results are discussed following the possibility that dysfunctions in the mechanisms of vigilance would be involved in the pathophysiology of schizophrenia.