Sleep disturbances in schizophrenia spectrum and bipolar disorders – a transdiagnostic perspective

Laskemoen, Jannicke Fjæra; Simonsen, Carmen; Büchmann, Camilla Bakkalia; Barrett, Elizabeth Ann; Bjella, Thomas; Lagerberg, Trine Vik; Vedal, Trude Jahr; Andreassen, Ole A.; Melle, Ingrid; Aas, Monica

doi:10.1016/j.comppsych.2019.02.006

Cited by 67 publications

(47 citation statements)

References 50 publications

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“…Sleep disturbances are based on items from a rating scale primarily designed to assess depressive symptoms (IDS-C). The four sleep items applied have nevertheless been found valuable in the prediction of diagnoses of sleep disorders (Gruber et al, 2009;Kaplan et al, 2011;Soehner et al, 2014;Sylvia et al, 2012) and have been used in previous studies (Laskemoen et al, 2019;Steinan et al, 2016aSteinan et al, , 2016b. As nightmares are common symptoms of trauma, and might cause frequent wake-ups that may lead to high insomnia scores, nightmare disorders should ideally have been assessed.…”

Section: Discussionmentioning

confidence: 99%

“…These four sleep items have also been validated as the measures of insomnia and hypersomnia, and have been shown to adequately predict a clinical diagnosis of sleep disorders (Gruber et al, 2009;Kaplan, Gruber, Eidelman, Talbot, & Harvey, 2011;Soehner, Kaplan, & Harvey, 2014;Sylvia et al, 2012). In line with previous studies (Laskemoen et al, 2019;Steinan et al, 2016aSteinan et al, , 2016b, we define the following sleep disturbances based on the IDS-C (reminding that these definitions represent current symptoms of sleep disturbances and are not diagnostic categories).…”

Section: Sleep Disturbancesmentioning

confidence: 97%

“…The items are rated on a four-point Likert scale (0-3) in which higher scores represent more subjective disturbance based on sleep experience over the past 7 days. IDS-C has been used in several prior studies to differentiate betweenand conceptualizesleep disturbances (Laskemoen et al, 2019;Steinan et al, 2016aSteinan et al, , 2016b. These four sleep items have also been validated as the measures of insomnia and hypersomnia, and have been shown to adequately predict a clinical diagnosis of sleep disorders (Gruber et al, 2009;Kaplan, Gruber, Eidelman, Talbot, & Harvey, 2011;Soehner, Kaplan, & Harvey, 2014;Sylvia et al, 2012).…”

Section: Sleep Disturbancesmentioning

confidence: 99%

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Sleep disturbance mediates the link between childhood trauma and clinical outcome in severe mental disorders

et al. 2020

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Background The experience of childhood trauma is linked to more severe symptoms and poorer functioning in severe mental disorders; however, the mechanisms behind this are poorly understood. We investigate the relationship between childhood trauma and sleep disturbances in severe mental disorders including the role of sleep disturbances in mediating the relationship between childhood trauma and the severity of clinical symptoms and poorer functioning. Methods In total, 766 participants with schizophrenia-spectrum (n = 418) or bipolar disorders (n = 348) were assessed with the Childhood Trauma Questionnaire. Sleep disturbances were assessed through the sleep items in the self-reported Inventory of Depressive Symptoms. Clinical symptoms and functioning were assessed with The Positive and Negative Syndrome Scale and the Global Assessment of Functioning Scale. Mediation analyses using ordinary least squares regression were conducted to test if sleep disturbances mediated the relationship between childhood trauma and the severity of clinical symptoms and poorer functioning. Results Symptoms of insomnia, but not hypersomnia or delayed sleep phase, were significantly more frequent in participants with childhood trauma experiences compared to those without. Physical abuse, emotional abuse, and emotional neglect were significantly associated with insomnia symptoms. Insomnia symptoms partly mediate the relationship between childhood trauma and the severity of positive and depressive/anxiety symptoms, in addition to poorer functioning. Conclusion We found frequent co-occurrence of childhood trauma history and current insomnia in severe mental disorders. Insomnia partly mediated the relationship between childhood trauma and the severity of clinical symptoms and functional impairment.

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Section: Discussionmentioning

confidence: 99%

Section: Sleep Disturbancesmentioning

confidence: 97%

Section: Sleep Disturbancesmentioning

confidence: 99%

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Sleep disturbance mediates the link between childhood trauma and clinical outcome in severe mental disorders

et al. 2020

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“…Sleep disturbances in subjects with schizophrenia included reduced slow-wave sleep, reduced total sleep time and efficiency, and increased rapid eye movement sleep latency that persisted after accounting for medication, social isolation, and the absence of a social routine (Chouinard et al, 2004; Wulff and Joyce, 2011; Zanini et al, 2013). In individuals with schizophrenia, poorer sleep quality correlated with greater symptom severity (Korenic et al, 2019; Laskemoen et al, 2019), and patients with disturbed circadian rhythms performed worse in cognitive tests compared with patients with normal circadian rhythms (Bromundt et al, 2011). In a study measuring both actigraphy and melatonin rhythms, a substantial portion of individuals with schizophrenia had severe disruptions of the circadian sleep/wake timing.…”

Section: Sleep and Circadian Disturbances Constitute A Fundamental Comentioning

confidence: 99%

Are Circadian Disturbances a Core Pathophysiological Component of Schizophrenia?

2020

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Schizophrenia is a multifactorial disorder caused by a combination of genetic variations and exposure to environmental insults. Sleep and circadian rhythm disturbances are a prominent and ubiquitous feature of many psychiatric disorders, including schizophrenia. There is growing interest in uncovering the mechanistic link between schizophrenia and circadian rhythms, which may directly affect disorder outcomes. In this review, we explore the interaction between schizophrenia and circadian rhythms from 2 complementary angles. First, we review evidence that sleep and circadian rhythm disturbances constitute a fundamental component of schizophrenia, as supported by both human studies and animal models with genetic mutations related to schizophrenia. Second, we discuss the idea that circadian rhythm disruption interacts with existing risk factors for schizophrenia to promote schizophrenia-relevant behavioral and neurobiological abnormalities. Understanding the mechanistic link between schizophrenia and circadian rhythms will have implications for mitigating risk to the disorder and informing the development of circadian-based therapies.

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“…Indeed, all gating disorders have been shown to be accompanied by sleep disturbances and sensitive to their negative impact. For example, the risk of sleep disturbances in schizophrenia or bipolar disorder is almost twice as high as that reported in healthy controls, with insomnia being the most frequently reported sleep disturbance across groups . Sleep disturbances are highly prevalent in bipolar disorder, and are often consequent to a reduced need for sleep in mania .…”

Section: Neurosteroids Are Involved In the Neurobehavioural Effects Omentioning

confidence: 99%

Neurobehavioural complications of sleep deprivation: Shedding light on the emerging role of neuroactive steroids

Frau

Traccis

Bortolato

2019

J Neuroendocrinology

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Sleep deprivation (SD) is associated with a broad spectrum of cognitive and behavioural complications, including emotional lability and enhanced stress reactivity, as well as deficits in executive functions, decision making and impulse control. These impairments, which have profound negative consequences on the health and productivity of many individuals, reflect alterations of the prefrontal cortex (PFC) and its connectivity with subcortical regions. However, the molecular underpinnings of these alterations remain elusive. Our group and others have begun examining how the neurobehavioural outcomes of SD may be influenced by neuroactive steroids, a family of molecules deeply implicated in sleep regulation and the stress response. These studies have revealed that, similar to other stressors, acute SD leads to increased synthesis of the neurosteroid allopregnanolone in the PFC. Whereas this up‐regulation is likely aimed at counterbalancing the detrimental impact of oxidative stress induced by SD, the increase in prefrontal allopregnanolone levels contributes to deficits in sensorimotor gating and impulse control, signalling a functional impairment of PFC. This scenario suggests that the synthesis of neuroactive steroids during acute SD may be enacted as a neuroprotective response in the PFC; however, such compensation may in turn set off neurobehavioural complications by interfering with the corticolimbic connections responsible for executive functions and emotional regulation.

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Sleep disturbances in schizophrenia spectrum and bipolar disorders – a transdiagnostic perspective

Cited by 67 publications

References 50 publications

Sleep disturbance mediates the link between childhood trauma and clinical outcome in severe mental disorders

Sleep disturbance mediates the link between childhood trauma and clinical outcome in severe mental disorders

Are Circadian Disturbances a Core Pathophysiological Component of Schizophrenia?

Neurobehavioural complications of sleep deprivation: Shedding light on the emerging role of neuroactive steroids

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