Sleep Disturbance Found to Be Significantly Greater in Patients at High Risk for Psychosis

Patients at clinical high risk (CHR) for psychosis appear to experience more sleep problems than those who do not show a heightened risk for psychosis, according to a study in Psychiatry Research. The report also found that sleep disturbance was related to greater positive and negative symptoms and worse overall functioning.

The results suggest that targeting sleep disturbance in CHR individuals may provide alternative means of treating the CHR syndrome, the study authors say.

Researchers from Columbia University Medical Center and the New York State Psychiatric Institute compared sleep disturbance in 194 help-seeking patients aged 13 to 30 who met criteria for CHR with 66 matched healthy comparison participants. The group used the Structured Interview for Psychosis-Risk Syndromes (SIPS) G1 (“Sleep Disturbance”) measure to assess sleep disturbance in all participants. The seven items of G1 are 0 (absence of sleep disturbance), 1 (restless sleep), 2 (hyposomnia), 3 (daytime fatigue), 4 (sleep pattern disruption), 5 (day/night reversal), and 6 (insomnia for two days). The Global Assessment of Functioning and Global Functioning Social and Role scales were used to evaluate social, occupational, and overall functioning.

The researchers found significant differences in positive symptoms, negative symptoms, sleep disturbance (SIPS G1), and general functioning between the two groups—the former three were greater in CHR subjects and the latter lesser in CHR. While no specific sleep items predicted conversion to psychosis or social and role functioning, sleep disturbance item 4 (sleep pattern disruption) and item 5 (day/night reversal) were related to greater positive symptoms. These two specific sleep disturbances and item 3 (daytime fatigue) were also significantly related to negative symptom severity. Sleep disturbance item 4 (sleep pattern disruption) was related to worse overall functioning.

“This study confirms previous findings of sleep disturbances [in CHR patients], offers new support and specificity to these findings, and is supportive of intervention studies targeting both negative symptoms and sleep disturbances,” the researchers stated. “Intervention studies will be an important future focus.”

For related information, see the Psychiatric News article “Clinicians Need More Training on Value of Sleep, Statement Says.”

(Image: iStock/Eva-Katalin)