Sleep disturbances prevalent during psychosis

Sleep disturbances were found to be prevalent throughout the course of psychosis, and different psychosis stages showed shared and distinct abnormalities, researchers reported in JAMA Psychiatry.

“Sleep disturbances, such as insomnia, are commonly reported by individuals with chronic psychosis and are associated with subsequent relapse. Altered sleep often precedes a psychotic episode in early psychosis, and disrupted sleep contributes to predicting transition to psychosis in youth at clinical high risk for psychosis,” Joelle Bagautdinova, MSc, of the department of neuroscience at the University of Pennsylvania, and colleagues wrote.

Bagautdinova and colleagues conducted a systematic review and meta-analysis to identify sleep abnormalities across psychosis stages. Sleep disturbance prevalence studies and case-control studies that reported on sleep quality, sleep architecture or sleep electroencephalography oscillations were included.

Fifty-nine studies with 6,710 patients and 977 controls were included. Sleep disturbance prevalence in pooled cases was 50% (95% CI, 40%-61%) and it was similar in each psychosis stage, the authors reported.

In addition, sleep quality was worse in pooled cases compared with standard controls (standardized mean difference [SMD], 1; 95% CI, 0.7-1.3). Sleep architecture alterations included higher sleep onset latency (SMD, 0.96; 95% CI, 0.62-1.3), higher wake after sleep onset (SMD, 0.5; 95% CI, 0.29-0.71), higher number of arousals (SMD, 0.45; 95% CI, 0.07-0.83), higher stage 1 sleep (SMD, 0.23; 95% CI, 0.06-0.4), lower sleep efficiency (SMD, –0.75; 95% CI, –0.98 to –0.52) and lower rapid eye movement density (SMD, 0.37; 95% CI, 0.14-0.6).

“Findings from these studies may help establish sleep as a core clinical target and research domain from prodromal to early and chronic stages of psychosis,” Bagautdinova and colleagues wrote.