TABLE 14 

Summary of studies assessing the effects of olanzapine (OLA) on sleep

StudyAgeDiagnosisDesign + Number of ParticipantsResultsAdverse EventsConclusion
Jakovljević et al. (2003)28–50Treatment-resistant PTSD with nightmares and insomniaCase series. OLA added to current treatment regimen. N = 5.All five patients improved rapidly after treatment initiation with olanzapine.No AEs were reported.OLA may be effective at reducing sleep disturbances in PTSD.
Khazaie et al. (2013)60Paradoxical insomniaCase report. OLA 5 mg/day added to treatment regimen. N = 1.After 6 wk, OLA treatment resulted in complete remission of symptoms.None listed.OLA may be effective at reducing symptoms of paradoxical insomnia.
Khazaie et al. (2013)Mean: 53.4; S.D.: 14.4Paradoxical insomnia8-wk randomized, open-label trial. OLA 10 mg/day vs. risperidone 4 mg/day. N = 29.Sleep quality measured with the Pittsburgh Sleep Quality Inventory showed significant improvement in both treatment groups, though improvement in OLA group was superior to risperidone group. In OLA group, baseline mean was 11.8 ± 2.3 and treatment mean was 2.6 ± 1.6, P < 0.001. In risperidone group, baseline mean was 11.1 ± 2.4 and treatment mean was 5 ± 3.8, P < 0.001. Between groups comparison yielded P < 0.04.No AEs were reported.OLA is effective at reducing symptoms of paradoxical insomnia.
Kluge et al. (2014)18–65Schizophrenia and review of the literature6-wk RCT single center. OLA 5-25 mg/day vs. clozapine 100–400 mg/day. During the first 2 wk, the dose range was restricted (OLA 10–15 mg/day, clozapine 25–200 mg/day). N = 30.OLA and clozapine increased TST and sleep efficiency, and decreased SOL. Concerning sleep stages, OLA increased SWS and decreased REM sleep.No clinically relevant symptoms of restless legs syndrome were observed. No other AEs were analyzed.OLA is effective in improving sleep in patients with schizophrenia.
Salin-Pasqual et al. (1999)Mean: 33.6; S.D.: 10.7SchizophreniaFive-night open-label polysomnographic study with OLA 10 mg/day administered for two nights. N = 20.OLA enhanced slow wave sleep and increased total sleep time. REM density increased and stage 1 decreased with OLA.None listed.OLA may increase slow wave sleep and total sleep time in schizophrenia.
Sharpley et al. (2000)33–60Healthy subjectsOne-dose crossover RCT. OLA 5 mg/day vs. OLA 10 mg/day vs. placebo. N = 9.OLA substantially increased slow wave sleep, by 59.1% and 83.3% for the 5 and 10 mg/day doses, respectively. OLA increased total sleep time.None listed.OLA increases slow wave sleep and total sleep time in healthy subjects.