A new study shows that irregular sleep patterns, dysregulation between sleep and wake cycles, and excessive daytime sleep are associated with worsening symptoms of schizophrenia.
The findings also showed that people with schizophrenia spectrum disorder (SSD) who lived in residential facilities experienced a rigorous daily routine, which correlated with a higher degree of negative symptoms.
Dr. Fabio Ferrarelli
Rigid routines were a problem for patients living in residential settings, said principal investigator Fabio Ferrarelli, MD, PhD. Medscape Medical NewsFerrarelli is an Associate Professor of Psychiatry at the University of Pittsburgh School of Medicine.
“Engaging in different activities at different times, with activities related to motivation and social interaction, can help improve difficult-to-treat negative symptoms,” he said.
of findings Published online on April 14 molecular psychiatry.
I need to increase my activity level
Although there is no shortage of studies on sleep disturbances in people with schizophrenia, studies that specifically focus on the relationship between rest-activity rhythm disturbances and symptoms of schizophrenia are lacking due to small sample sizes or lack of controls. limited, researchers note.
To address this research gap, researchers recruited 230 SSD patients from participating residential facilities and communities across Italy. Participants included 108 healthy control participants, 54 community-dwelling patients with her SSD, and receiving outpatient services. Also, 68 of her SSD patients lived in residential facilities.
All participants wore the actigraph for seven consecutive days so that researchers could monitor their sleep-wake patterns.
Compared to healthy control participants, both SSD groups had longer total sleep time and spent more time resting or being passive (P. < .001). In contrast, participants in the healthy control group were much more active.
Part of the explanation for this may be that most of the control participants had a job or were attending school. It is so potent that some patients may sleep up to 15 hours a day, he notes.
SSD resident participants had higher daily stability and daily rest-activity-rest fragmentation than healthy control participants or community-dwelling SSD patients (P. < .001). There was also a higher level of negative symptoms in SSD resident participants than in the SSD community resident group.
Taken together, Ferrarelli and his team interpreted these findings to mean that they may reflect premature aging or neurodegenerative processes in patients with more severe schizophrenia.
Another explanation, Dr. Ferrerelli said, was that the strict routine at the residential facility may have exacerbated the negative symptoms. It’s important to add variety to your combinations. Engaging in different activities at different times of the day may help patients with residential SSD overcome the negative symptoms of the disorder.
Participants were recruited in Italy, but Ferrarelli said he believes the findings can be generalized.
A two-way relationship?
Comments on survey results Medscape Medical NewsThe findings echo “the well-known clinical observation that people with SSD spend more time in bed and have more sleep dysregulation,” said Macheri Keshavan, M.D., Ph.D., professor of psychiatry at Harvard Medical School in Boston, Massachusetts. is consistent with
Dr. Maccheri Keshavan
“Negative symptoms are also common, especially in homebound patients. However, it is not known whether excessive sleepiness and reduced physical activity cause negative symptoms, or vice versa, or whether there is a two-way relationship. It is difficult to determine causation because there is no correlation,” said Keshavan.
he emphasized that physical exercise is known improve sleep quality For people with mental illness Improved negative symptoms“A helpful approach in clinical practice is to increase activity levels, especially physical activity such as walking and gardening.”
Keshavan said he would like to see future research focusing on whether interventions such as aerobic exercise improve sleep quality and negative symptoms.
He also said it would be ideal for future studies to examine the characteristics of sleep alterations in schizophrenia.
“For example, in schizophrenia, we sleep longer, but studies show that less time is spent in deep sleep. Sleep spindles, which are important for consolidating memories during sleep, are also reduced. These Correcting the deficit may improve negative symptoms and cognitive deficits,” he added.
This study was funded by the Italian Ministry of Health and the National Institute of Mental Health. There were no conflicts of interest.
Mole Psychiatry. Published online on April 14, 2023. full text
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