Sleep in first‐episode schizophrenia patients, their unaffected siblings and healthy controls: A comparison

Fekih‐Romdhane, Feten; Nefzi, H.; Sassi, Hadhami; Chérif, W.; Cheour, Majda

doi:10.1111/eip.13058

Cited by 10 publications

(12 citation statements)

References 67 publications

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“…Following preliminary screening of the titles and/or abstracts, 1762 were excluded accordingly. Among the 32 references that were reviewed in detail, 13 independent studies were selected for systematic review and meta-analysis including 537 individuals with an early stage and 360 healthy controls (Fekih-Romdhane et al, 2020; Guenole et al, 2014; Kaskie et al, 2019; Lederman et al, 2017; Lunsford-Avery et al, 2015; Manoach et al, 2014; Poe et al, 2017; Poulin et al, 2003; Riemann et al, 1995; Stowkowy et al, 2020; Yazihan and Yetkin, 2020; Zanini et al, 2015).…”

Section: Resultsmentioning

confidence: 99%

“…UHR samples were UHR-P and diagnosed by the CAARMS for 1 study (Lederman et al, 2017) or the SIPS for 3 studies (Lunsford-Avery et al, 2015; Poe et al, 2017; Stowkowy et al, 2020), or both UHR-P and UHR-BAP as diagnosed using OYH criteria for 2 studies (Stowkowy et al, 2020; Zanini et al, 2015). FE samples were FE-P with a duration of psychosis from 1 to 6 months in 5 studies (Forest et al, 2007; Guenole et al, 2014; Kaskie et al, 2019; Poulin et al, 2003; Yazihan and Yetkin, 2020), or FE-SZ with a duration of psychosis from 6 to 24 months in 4 studies (Fekih-Romdhane et al, 2020; Lederman et al, 2017; Manoach et al, 2014; Riemann et al, 1995). FE was diagnosed using DSM criteria in all 13 retained studies.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Subjective sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI) total score in six studies that provided subjective sleep data (Fekih-Romdhane et al, 2020; Lederman et al, 2017; Lunsford-Avery et al, 2015; Poe et al, 2017; Stowkowy et al, 2020; Zanini et al, 2015). Two studies used the Epworth Sleepiness Scale, which was not sufficient for meta-analysis (Fekih-Romdhane et al, 2020; Zanini et al, 2015). Sleep continuity, duration, initiation and sleep architecture were measured in nine studies among which one used actigraphy (Lunsford-Avery et al, 2015) and eight used polysomnography recordings (Forest et al, 2007; Guenole et al, 2014; Kaskie et al, 2019; Manoach et al, 2014; Poulin et al, 2003; Riemann et al, 1995; Yazihan and Yetkin, 2020; Zanini et al, 2015).…”

Section: Resultsmentioning

confidence: 99%

“…Among the 13 studies retained for the systematic review and meta-analysis, 4 studies assessed UHR samples Australian & New Zealand Journal of Psychiatry, 56(9) (Lunsford-Avery et al, 2015;Poe et al, 2017;Stowkowy et al, 2020;Zanini et al, 2015), 9 examined FE samples (Fekih-Romdhane et al, 2020;Forest et al, 2007;Guenole et al, 2014;Kaskie et al, 2019;Manoach et al, 2014;Poulin et al, 2003;Riemann et al, 1995;Yazihan and Yetkin, 2020) and 1 involved both (Lederman et al, 2017). UHR samples were UHR-P and diagnosed by the CAARMS for 1 study (Lederman et al, 2017) or the SIPS for 3 studies (Lunsford-Avery et al, 2015;Poe et al, 2017;Stowkowy et al, 2020), or both UHR-P and UHR-BAP as diagnosed using OYH criteria for 2 studies (Stowkowy et al, 2020;Zanini et al, 2015).…”

Section: Characteristics Of Selected Studiesmentioning

confidence: 99%

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Sleep disturbances in early clinical stages of psychotic and bipolar disorders: A meta-analysis

Dondé

Jaffiol

Khouri

et al. 2021

Aust N Z J Psychiatry

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Objective: To provide a qualitative view and quantitative measure of sleep disturbances across and between early stages – clinical ultra high-risk and first episode – of psychotic and bipolar disorders. Methods: Electronic databases (PubMed, Cochrane, Embase, PsychINFO) were searched up to March 2021 for studies comparing sleep measures between individuals with an early stage and controls. Standard mean deviations (Cohen’s d effect sizes) were calculated for all comparisons and pooled with random-effects models. Chi-square tests were used for direct between-subgroups (ultra high-risk vs first episode) comparisons of standard mean deviations. The effects of age, sex ratio, symptoms and treatment were examined in meta-regression analyses. Results: A database search identified 13 studies that contrasted sleep measures between individuals with an early stage ( N = 537) and controls ( N = 360). We observed poorer subjective sleep quality (standard mean deviation = 1.32; 95% confidence interval, [1.01, 1.62]), shorter total sleep time (standard mean deviation =−0.44; 95% confidence interval, [−0.67, −0.21]), lower sleep efficiency (standard mean deviation = −0.72; 95% confidence interval, [−1.08, −0.36]), longer sleep onset latency (standard mean deviation = 0.75; 95% confidence interval, [0.45, 1.06]) and longer duration of wake after sleep onset (standard mean deviation = 0.49; 95% confidence interval, [0.21, 0.77]) were observed in early stages compared to controls. No significant differences were observed for any of the reported electroencephalographic parameters of sleep architecture. No significant between-subgroups differences were observed. Meta-regressions revealed a significant effect of the age and the antipsychotic status on subjective measures of sleep. Conclusion: The early stage population presents with significant impairments of subjective sleep quality continuity, duration and initiation. Systematic assessments of sleep in early intervention settings may allow early identification and treatment of sleep disturbances in this population.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Characteristics Of Selected Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Sleep disturbances in early clinical stages of psychotic and bipolar disorders: A meta-analysis

Dondé

Jaffiol

Khouri

et al. 2021

Aust N Z J Psychiatry

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Sleep Abnormalities in Different Clinical Stages of Psychosis

et al. 2023

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ImportanceAbnormal sleep is frequent in psychosis; however, sleep abnormalities in different stages (ie, clinical high risk for psychosis [CHR-P], early psychosis [EP], and chronic psychosis [CP]) have not been characterized.ObjectiveTo identify sleep abnormalities across psychosis stages.Data SourcesWeb of Science and PubMed were searched between inception and June 15, 2022. Studies written in English were included.Study SelectionSleep disturbance prevalence studies and case-control studies reporting sleep quality, sleep architecture, or sleep electroencephalography oscillations in CHR-P, EP, or CP.Data Extraction and SynthesisThis systematic review and meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Stage-specific and pooled random-effects meta-analyses were conducted, along with the assessment of heterogeneity, study quality, and meta-regressions (clinical stage, sex, age, medication status, and psychotic symptoms).Main Outcomes and MeasuresSleep disturbance prevalence, self-reported sleep quality, sleep architecture (total sleep time, sleep latency, sleep efficiency, nonrapid eye movement, rapid eye movement stages, and number of arousals), and sleep electroencephalography oscillations (spindle density, amplitude, and duration, and slow wave density).ResultsFifty-nine studies with up to 6710 patients (n = 5135 for prevalence) and 977 controls were included. Sleep disturbance prevalence in pooled cases was 50% (95% CI, 40%-61%) and it was similar in each psychosis stage. Sleep quality was worse in pooled cases vs controls (standardized mean difference [SMD], 1.00 [95% CI, 0.70-1.30]). Sleep architecture alterations included higher sleep onset latency (SMD [95% CI]: pooled cases, 0.96 [0.62-1.30]; EP, 0.72 [0.52-0.92]; CP, 1.36 [0.66-2.05]), higher wake after sleep onset (SMD [95% CI]: pooled cases, 0.5 [0.29-0.71]; EP, 0.62 [0.34-0.89]; CP, 0.51 [0.09-0.93]), higher number of arousals (SMD [95% CI]: pooled cases, 0.45 [0.07-0.83]; CP, 0.81 [0.30-1.32]), higher stage 1 sleep (SMD [95% CI]: pooled cases, 0.23 [0.06-0.40]; EP, 0.34 [0.15-0.53]), lower sleep efficiency (SMD [95% CI]: pooled cases, −0.75 [−0.98 to −0.52]; EP, −0.90 [−1.20 to −0.60]; CP, −0.73 [−1.14 to −0.33]), and lower rapid eye movement density (SMD [95% CI]: pooled cases, 0.37 [0.14-0.60]; CP, 0.4 [0.19-0.77]). Spindle parameter deficits included density (SMD [95% CI]: pooled cases, −1.06 [−1.50 to −0.63]; EP, −0.80 [−1.22 to −0.39]; CP, −1.39 [−2.05 to −0.74]; amplitude: pooled cases, −1.08 [−1.33 to −0.82]; EP, −0.86 [−1.24 to −0.47]; CP, −1.25 [−1.58 to −0.91]; and duration: pooled cases: −1.2 [−1.69 to −0.73]; EP, −0.71 [−1.08 to −0.34]; CP, −1.74 [−2.10 to −1.38]). Individuals with CP had more frequent arousals vs CHR-P (z = 2.24, P = .02) and reduced spindle duration vs EP (z = −3.91, P &lt; .001).Conclusions and RelevanceIn this systematic review and meta-analysis, sleep disturbances were found to be prevalent throughout the course of psychosis, and different psychosis stages showed both shared and distinct abnormalities in sleep quality, architecture, and spindles. These findings suggest that sleep should become a core clinical target and research domain from at-risk to early and chronic stages of psychosis.

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Insomnia Mediates the Relationship Between Aggression Indicators and Positive Psychotic Experiences in a Large Community-Based Adult Sample

Fekih‐Romdhane

Malaeb

Loch

et al. 2023

Int J Ment Health Addiction

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Sleep in first‐episode schizophrenia patients, their unaffected siblings and healthy controls: A comparison

Cited by 10 publications

References 67 publications

Sleep disturbances in early clinical stages of psychotic and bipolar disorders: A meta-analysis

Sleep disturbances in early clinical stages of psychotic and bipolar disorders: A meta-analysis

Sleep Abnormalities in Different Clinical Stages of Psychosis

Insomnia Mediates the Relationship Between Aggression Indicators and Positive Psychotic Experiences in a Large Community-Based Adult Sample

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