0652 Subjective and objective sleep disturbances in individuals with psychotic disorders and their first-degree relatives

Abstract

Introduction Sleep disturbances commonly precede or precipitate psychotic disorders. The primary goals of the present study are to compare self-reports of sleep quality and chronotype with objective measurements and to investigate their relations with clinical symptoms and psychotic-like experiences (PLEs) in early course, minimally treated patients with psychotic disorders (PSY), their young, first-degree relatives (familial high risk: FHR) and matched controls. Methods Seventy-three participants (13-35 yrs, n(PSY)=19, n(Controls)=30, n(FHR)=24) completed self-report measures of sleep quality (PSQI), chronotype (MEQ) and PLEs (Chapman Scales). Sleep quality and chronotype were objectively measured with actigraphy (average duration of measurements: 12 days). Psychosis and FHR groups were rated on the Positive and Negative Syndrome Scale (PANSS) by an expert clinician. Results PSQI was significantly different between the groups (F(2,67)= 11.8, p< .001), this reflected that compared to controls, both the psychosis (p<.001) and FHR (p=002) groups had worse self-reported sleep quality. For objective sleep quality, we observed a main effect of day-to-day variability in total sleep time (F(2,46)= 3.24, p=.048) , with significantly higher variability in PSY than controls (p= .038). Symptom severity in PSY and FHR correlated with PSQI (r=.31, p=.047), reflecting that those with higher psychotic symptoms had more sleep disturbances. PLEs in the entire sample also correlated with PSQI (r=.41, p<.001). We did not observe any correlations between objective sleep quality and symptoms. There were no group differences in chronotype (subjective or objective). Chronotype did not correlate with symptoms or PLEs. Conclusion While both early-course patients and their first-degree relatives report significant sleep disturbances, objective measurements corroborate this only for day-to-day variability in sleep duration in the patient group. Further, symptom severity and PLEs correlate only with subjective sleep disturbances. These findings highlight the importance of objective assessment of sleep quality in this population and are in line with our polysomnography work that reveals an isolated deficit in NREM sleep in the context of similar sleep duration and architecture in psychosis. Support (if any) K01 MH114012 (Baran)