TY - JOUR
T1 - Sleep disturbances and the At Risk Mental State
T2 - A systematic review and meta-analysis
AU - Clarke, Latoya
AU - Chisholm, Katharine
AU - Cappuccio, Francesco P.
AU - Tang, Nicole K.Y.
AU - Miller, Michelle A.
AU - Elahi, Farah
AU - Thompson, Andrew D.
PY - 2021/1
Y1 - 2021/1
N2 - Aims: To synthesise and investigate how sleep disturbances relate to psychotic symptoms, functioning and Quality of Life (QoL) in At Risk Mental State (ARMS) youth. Method: A comprehensive search of six databases (MEDLINE, PsycINFO, Embase, CINAHL, Web of Science and CENTRAL) was conducted. Eligible studies provided data on sleep disturbances or disorders in ARMS patients. Results: Sixteen studies met the inclusion criteria (n = 1962 ARMS patients) including 7 cross-sectional studies, 2 RCT's and 7 cohort studies. Narrative synthesis revealed that self-reported sleep (e.g., general disturbances, fragmented night time sleep and nightmares) was poorer among ARMS patients compared to healthy controls. In the limited studies (n = 4) including objective measurements of sleep disturbances, ARMS patients experienced higher levels of movement during sleep, more daytime naps and increased sleep latency compared to controls. Furthermore, sleep disturbances were associated with attenuated psychotic symptoms and functional outcomes cross-sectionally and longitudinally. Only one study investigated the relationship between sleep and QoL. The exploratory meta-analysis revealed a significant difference in self-reported sleep disturbances measured by the PSQI (mean difference in score: 3.30 (95% CI 1.87, 4.74), p < 0.00001) and SIPS (mean difference in score: 1.58 (95% CI 0.80, 2.35), p < 0.00001) of ARMS patients compared to control groups. Conclusions: ARMS individuals report impaired sleep quality and reduced sleep quantity compared to healthy controls. However, further research is needed to explore the longitudinal relationship between sleep disruptions and QoL in early psychosis. Significant variations in how sleep is measured across studies highlight a need to assess disturbances to sleep using robust and consistent approaches in this patient group.
AB - Aims: To synthesise and investigate how sleep disturbances relate to psychotic symptoms, functioning and Quality of Life (QoL) in At Risk Mental State (ARMS) youth. Method: A comprehensive search of six databases (MEDLINE, PsycINFO, Embase, CINAHL, Web of Science and CENTRAL) was conducted. Eligible studies provided data on sleep disturbances or disorders in ARMS patients. Results: Sixteen studies met the inclusion criteria (n = 1962 ARMS patients) including 7 cross-sectional studies, 2 RCT's and 7 cohort studies. Narrative synthesis revealed that self-reported sleep (e.g., general disturbances, fragmented night time sleep and nightmares) was poorer among ARMS patients compared to healthy controls. In the limited studies (n = 4) including objective measurements of sleep disturbances, ARMS patients experienced higher levels of movement during sleep, more daytime naps and increased sleep latency compared to controls. Furthermore, sleep disturbances were associated with attenuated psychotic symptoms and functional outcomes cross-sectionally and longitudinally. Only one study investigated the relationship between sleep and QoL. The exploratory meta-analysis revealed a significant difference in self-reported sleep disturbances measured by the PSQI (mean difference in score: 3.30 (95% CI 1.87, 4.74), p < 0.00001) and SIPS (mean difference in score: 1.58 (95% CI 0.80, 2.35), p < 0.00001) of ARMS patients compared to control groups. Conclusions: ARMS individuals report impaired sleep quality and reduced sleep quantity compared to healthy controls. However, further research is needed to explore the longitudinal relationship between sleep disruptions and QoL in early psychosis. Significant variations in how sleep is measured across studies highlight a need to assess disturbances to sleep using robust and consistent approaches in this patient group.
KW - At Risk Mental State
KW - Psychosis
KW - Sleep
KW - Ultra high risk
KW - Youth mental health
UR - http://www.scopus.com/inward/record.url?scp=85087511402&partnerID=8YFLogxK
UR - https://www.sciencedirect.com/science/article/pii/S0920996420303790?via%3Dihub
U2 - 10.1016/j.schres.2020.06.027
DO - 10.1016/j.schres.2020.06.027
M3 - Review article
AN - SCOPUS:85087511402
SN - 0920-9964
VL - 227
SP - 81
EP - 91
JO - Schizophrenia Research
JF - Schizophrenia Research
ER -