Symptoms of Sleep Disorders Prevalent in Psychiatric Illnesses

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The authors argue that identifying and treating sleep disorders during early stages may have a positive impact on outcomes in psychiatric patients.

More than 40% of people receiving outpatient treatment for psychiatric disorders experience symptoms of sleep disorders, with 26.3% of these patients having symptoms of 2 sleep disorders and 10.4% having symptoms of 3 sleep disorders, according to results of a recent study published in Psychiatry Research.

Although it is known that people who have psychiatric disorders often have sleep disturbances, few studies have investigated the prevalence of specific sleep disorders and symptoms of these disorders among these patients.

Aditi Hombali, MS, Research Division, Institute of Mental Health, Singapore, and colleagues conducted a cross-sectional study of 400 people between the ages of 21 and 65 years who attended outpatient clinics and had a primary diagnosis of schizophrenia or a mood or anxiety disorder. They collected sociologic and demographic information and administered screening questions to identify specific symptoms of sleep disorders.

The prevalence of symptoms of specific sleep disorders among the 400 patients was 12.5% for narcolepsy, 14.5% for sleep breathing disorder, 14.8% for restless leg syndrome/periodic limb movements of sleep (RLS/PLMS), 4.5% for circadian rhythm disorder, and 13.8% for parasomnia. Approximately two-thirds of these patients reported symptoms of insomnia. The results of a logistic regression analysis indicate that ethnicity, level of education, level of physical activity, and insomnia were associated with symptoms of sleep disorders. Individuals of Chinese origin were significantly less likely to have symptoms of sleep disorder than those of other ethnic groups, who had an odds ratio (OR) of 2.224 (P =.002). Individuals with more education (postsecondary or more) were less likely to have symptoms of sleep disorders (OR=0.538, P =.017) and those who had a higher level of physical activity were significantly less likely to experience sleep disorder symptoms. In contrast, those with insomnia were at the highest risk of having sleep disorder symptoms (OR=3.366, P ≤.001). 

RLS/PLMS was less likely to occur in older patients than in younger ones (OR=0.332, P =.001) and in those with more than a secondary level education (OR=0.495, P =.046). Obesity was associated with sleep breathing disorder (OR=2.464; P =.004) and those with high levels of physical activity were less likely to have symptoms of sleep breathing disorder (OR=0.453; P =.011). Patients with insomnia were more likely to also have symptoms of narcolepsy (OR=2.368, P =.030), PLMS/RLS (OR=4.616, P ≤.001) or parasomnia (OR=3.317, P =.006).

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Regarding associations with specific psychiatric disorders, those with anxiety were most likely to experience symptoms of sleep disorders (48.0%), whereas 34.1% of those with schizophrenia and 41.1% of those with mood disorders reported such symptoms.

The authors argue that identifying and treating sleep disorders during early stages may have a positive impact on outcomes in people being treated for psychiatric disorders. They also recommend large-scale prospective studies to corroborate these findings.


Hombali A, Seow E, Yan Q, et al. Prevalence and correlates of sleep disorder symptoms in psychiatric disorders [published online July 6, 2018]. Psychiatry Res. doi:10.1016/jpsychres.2018.07.009