Sleep Disorders Linked to Nonaffective Psychosis in Young Adults

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Sleep disturbances such as low sleep quality or shorter sleep duration may be associated with increased psychotic experiences in nonclinical, clinical, and at-risk populations.
Sleep disturbances such as low sleep quality or shorter sleep duration may be associated with increased psychotic experiences in nonclinical, clinical, and at-risk populations.

A majority of young adults with nonaffective psychosis were found to have severe sleep disorders, according to findings published in Schizophrenia Bulletin.

Researchers assessed 60 adult outpatients aged 18 to 30 and diagnosed with nonaffective psychosis for the presence of sleep disorders, taking into account severity and treatment. They relied on structured diagnostic interviews, sleep diaries, and actigraphy to cull results.

The results showed that 80% of participants screened positive for at least one sleep disorder. Of the 80% who screened positive, 50% had insomnia and 48.3% had nightmare disorder. 

The researchers also found that most patients averaged 3.3 sleeping disorders each. According to sleep diaries, sleep duration and efficiency were lower in participants with insomnia compared with those who did not have insomnia. Sleep disorders were also associated with more severe paranoia, hallucinations, and cognitive disorganization compared with those who did not have sleep disorders. There were no significant differences in medication doses between individuals with insomnia compared with those who did not have insomnia. The findings, with respect to drug dose, were similar for those who had nightmares compared with those who did not.

Researchers conclude that “four-fifths of the patients were found to have a comorbid sleep disorder. These were not minor sleep issues — the majority of disorders were rated as severe in their chronicity, frequency, and distress or impairment." They note study limitations such as the inability to screen for sleep apnea and lack of polysomnography. They emphasize that treatment for sleep disorders among individuals with psychosis is worthy of greater clinical attention.

One author reported providing clinical consultancy to Sleepio (Big Health Ltd.) at the time the study was conducted.

Reference

Reeve S, Sheaves B, Freeman D. Sleep disorder in early psychosis: incidence, severity, and association with clinical symptoms [published online September 8, 2018]. Schizophr Bull. doi: 10.1093/schbul/sby129

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