21 Sep Sleep and Mental Health – Part 3
A systematic review of the nature and correlates of sleep disturbance in early psychosis
A systematic review of the nature and correlates of sleep disturbance in early psychosis. Davies, Gabriel et al. Sleep Medicine Reviews, Volume 31 , 25 – 38.
Sleep disturbances are common with schizophrenia and are associated with increased symptom severity, neurocognitive deficits and reduced quality of life. A recent systematic review aims to synthesise and evaluate the available data exploring sleep in early psychosis, with two key research questions:
1) What is the nature of sleep disturbance in early psychosis?
2) What are the correlates of sleep disturbance in early psychosis?
The preliminary evidence suggests self-reported sleep disturbances are prevalent in early psychosis and may be associated with symptom severity, as well as elevated rates of both help-seeking and suicidality.
Conclusion: This study suggests that poor sleep is prevalent within population with schizophrenia and may be linked to increased risk of psychotic symptoms.
Sleep disturbances are associated with psychotic experiences: Findings from the National Comorbidity Survey Replication
Sleep disturbances are associated with psychotic experiences: Findings from the National Comorbidity Survey Replication Oh, Hans Y. et al. Schizophrenia Research , Volume 171 , Issue 1 , 74 – 78.
Reported sleep disturbances have been linked to psychotic experiences in the general adult populations of multiple countries, but this association has yet to be confirmed in the United States. This study analysed a subsample (n=2304) of the National Comorbidity Survey Replication, and found when compared with those who did not report sleep problems, individuals with sleep disturbances lasting two weeks or longer over the past 12 months were significantly more likely to report at least one psychotic experience during that same time frame. Specifically, difficulty falling asleep, waking up during the night, early morning awakenings, and feeling sleepy during the day were each associated with greater odds (OR: 3.04, p = 0.001) of reporting psychotic experiences over the past year. However, only difficulty falling asleep and early morning awakenings were still significant after adjusting for comorbid disorders. Reporting three or four types of sleep disturbances was especially predictive of psychotic experiences. These findings underscore the importance of detecting and reducing sleep problems among individuals who report psychotic experiences.
The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis
The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis. Freeman, Daniel et al. The Lancet Psychiatry , Volume 4 , Issue 10 , 749 – 758.
Background Sleep difficulties might be a contributory causal factor in the occurrence of mental health problems. This study was to determine whether treating insomnia with cognitive behavioural therapy (CBT) leads to a reduction in paranoia and hallucinations. They found sleep intervention at 10 weeks reduced insomnia (adjusted difference 4·78, 95% CI 4·29 to 5·26, Cohen’s d=1·11; p<0·0001), paranoia (–2·22, –2·98 to –1·45, Cohen’s d=0·19; p<0·0001), and hallucinations (–1·58, –1·98 to –1·18, Cohen’s d=0·24; p<0·0001). Insomnia was a mediator of change in paranoia and hallucinations. This study provides strong evidence that insomnia is a causal factor in the occurrence of psychotic experiences and other mental health problems. The treatment of disrupted sleep might require a higher priority in mental health provision.