summary: Those with schizophrenia who had irregular sleep patterns, very strict daily routines, and irregular sleep-wake patterns had worse symptoms associated with schizophrenia and a poorer quality of life.
source: University of Pittsburgh
In a paper published today in Molecular PsychiatryA team of scientists from the University of Pittsburgh in collaboration with researchers in Italy described common patterns of sleep disturbances and irregularities in circadian rhythms of rest and activity across patients with schizophrenia spectrum disorder, or SSD.
Using wrist monitors that measure activity and rest as proxies for alertness and sleep, researchers found that individuals with SSD who reside in psychiatric hospitals and those who manage their condition in outpatient settings have irregular sleep patterns, irregular transitions between sleep-wake cycles, and routines. A very strict daily routine was predictive of worse symptoms of SSD and associated with poorer quality of life.
“Regulating your sleep-wake cycles is important to your overall health and our findings can also be extended to people without underlying mental health conditions,” said assistant professor of psychiatry and lead author of the study Fabio Ferrarilli, MD, PhD. “Most people can benefit from better sleep habits and more attention to their daily routines by incorporating activity and variety into their daily lives.”
The effects of interrupted sleep have long been studied in the context of physical and mental health, and the well-established research literature indicates that people with a severe sleep disorder have more difficulty falling asleep and getting less rest than people without underlying mental health conditions.
In addition, sedative medications used to control symptoms of SSD are known to alter sleep and extend the time patients spend resting up to 15 hours per day. Too much sleep can have negative consequences for symptoms of SSD, says Ferrarilli.
“It’s important to be aware of how the medicines we prescribe to patients affect their health more broadly,” he said. “Our study shows that 12 to 15 hours of sleep can be harmful, and it is important to avoid over-prescribing sedatives and to use the lowest possible dose.”
In the study of 250 participants, including nearly 150 inpatient and outpatient SSD patients representing one of the largest cohorts among published studies on sleep and SSD, researchers measured participants’ activity and rest throughout the day and night by asking them to wear a bracelet Wrist that detects motion and acceleration.
The scientists did not track brain waves during sleep or distinguish between different stages of sleep — such as REM and deep sleep — something they plan to do in future studies. However, the results were robust and consistent.
They found that inpatient and outpatient SSD subjects tended to have fewer active hours during the day and spent more time sleeping or passively resting than healthy controls.
In addition, the inpatients had more fragmented sleep and abrupt transitions between rest and activity compared to the outpatient group. Inpatients also showed more rigid rhythms of rest and daily activity than outpatients, and those measures were associated with a greater degree of negative mental health symptoms, including decreased motivation to interact with others and a decreased ability to experience pleasure.
“The consistency between the two groups of patients was somewhat surprising to us,” Ferrarilli said.
“But, interestingly, we found that inpatients had more stable daily routines. We tend to think of a stable routine as a good thing, but when those routines get too strict, it can become a problem. In our study, this rigidity was in rhythms.” The daily study was closely associated with the severity of negative mental health symptoms in resident schizophrenic patients.
The researchers say it is not possible to use signs of a sleep disorder to diagnose SSD because the symptoms overlap with other mental health conditions, such as dementia. But changing your daily routine and incorporating movement into your life are two simple steps everyone can take to improve and protect brain health.
“Especially as people get older, we tend to get deeper into our routine,” Ferrarilli said.
“Routine provides a sense of control over our lives and can be very beneficial. But if a routine is too rigid, it can backfire. Keeping your sleep schedule consistent while mixing up your daily tasks and splitting them up across different days of the week is a good way to add variety to your schedule and improve your health.” The long-term “.
Additional authors of the study include Ahmad Maiele, PhD, Alice Lajoie, PhD, Stephen Smagula, PhD, James Wilson, PhD, both Pitt as well as Giovanni Di Girolamo, PhD. D., and the DIAPASON consortium from Italy.
Funding: This research was supported by the National Institute of Mental Health with grant number R01 MH113827.
About this search for schizophrenia news
author: Anastasia Gorelova
source: University of Pittsburgh
communication: Anastasia Gorelova – University of Pittsburgh
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“Common and characteristic abnormalities in sleep-wake patterns and their relationship to negative symptoms in patients with schizophrenia spectrum disorder” by Fabio Ferrarilli et al. Molecular Psychiatry
a summary
Common and characteristic abnormalities in sleep-wake patterns and their relationship to negative symptoms in patients with schizophrenia spectrum disorder
Sleep, activity, and rhythm (RAR) disturbances are commonly reported in patients with schizophrenia spectrum disorder (SSD).
However, an in-depth characterization of sleep/RAR alterations in SSD, including patients in different treatment settings, and the relationship between these alterations and SSD clinical features (eg, negative symptoms) is lacking. SSD (n= 137 in all, n= 79 residential f n= 58 outpatients) and healthy control (HC) subjects (n= 113) for the DiAPAson project.
Participants wore the ActiGraph for seven consecutive days to monitor RAR’s usual sleep patterns. Duration of sleep/rest, activity (eg, M10, calculated over the 10 most active hours), rhythm segmentation within days (eg, circadian variance, IV; beta, severity of changes in active rest), and regularity of rhythm across days ( that is, inter-diary stability, IS) in each study participant.
Negative symptoms in SSD patients were assessed with the Brief Negative Symptoms Scale (BNSS). Both SSD groups showed lower M10 and longer sleep/rest duration versus HC, whereas only the resident patients had more fragmented and irregular rhythms than HC.
Compared to outpatients, inpatients had a lower M10 and a higher beta, IV, and IS. Furthermore, inpatients had worse BNSS scores than outpatients, and higher IS contributed to intergroup differences in BNSS score intensities.
Altogether, the SSD population and outpatients had both common and unique abnormalities on measures of sleep/RAR versus HC and in relation to each other, which also contributed to the severity of the patients’ negative symptoms.
Future work will help determine whether improving some of these measures might improve quality of life and clinical symptoms for patients with SSD.