High Resolution Examination of the Role of Sleep Disturbance in Predicting Functioning and Psychotic Symptoms in Schizophrenia: A Novel Experience Sampling Study
High Resolution Examination of the Role of Sleep Disturbance in Predicting Functioning and Psychotic Symptoms in Schizophrenia: A Novel Experience Sampling Study
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DOI：
10.1037/abn0000180
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发表时间：
2016-08-01
影响因子：
4.6
通讯作者：
Kyle, Simon D.
中科院分区：
文献类型：
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作者：
Mulligan, Lee D.;Haddock, Gillian;Kyle, Simon D.
睡眠障碍在精神分裂症中很常见，但其在预测功能和精神病症状中的作用尚未得到严格的检验。本研究的目的是对被诊断为精神分裂症的患者夜间睡眠与第二天功能和精神病症状之间的关系进行前瞻性、高分辨率的检查。经验抽样方法与活动记录仪和睡眠日记相结合，对22名诊断为精神分裂症的患者进行了7天的研究。根据伪随机时间表，每天5点收集情绪、精神病症状和功能的瞬时评估。通过多级建模来评估变量之间的联系。客观和主观睡眠障碍预测第二天功能下降，在控制精神病症状严重程度后仍然显著。睡眠碎片化程度的增加和主客观睡眠效率的降低预示着第二天更严重的幻听，而客观睡眠碎片化程度的增加和主观睡眠质量的降低预示着更严重的偏执和控制妄想。对觉醒的负面影响介导了这些关系的一部分（范围：17.9-57.3%）。我们首次表明，睡眠障碍是诊断为精神分裂症的人第二天功能受损和精神病症状严重程度的预测因素。因此，针对睡眠的干预措施可能有可能直接或间接地增强精神病患者的功能和症状恢复。
Sleep disturbance is common in schizophrenia, but its role in predicting functioning and psychotic symptoms has yet to be rigorously examined. The purpose of this study was to conduct a prospective, high-resolution examination of the relationship between nightly sleep and next-day functioning and psychotic symptoms in people with a diagnosis of schizophrenia. Experience sampling methodology was integrated with actigraphy and sleep diaries across 7 days in 22 patients with a diagnosis of schizophrenia. Momentary assessments of mood, psychotic symptoms, and functioning were gathered at 5 points each day following pseudorandom schedules. Multilevel modeling was performed to evaluate the links between variables. Objective and subjective sleep disturbance predicted reduced next-day functioning, which remained significant after controlling for psychotic symptom severity. Increased sleep fragmentation and reduced subjective and objective sleep efficiency predicted greater next-day auditory hallucinations, whereas increased objective sleep fragmentation and reduced subjective sleep quality predicted greater paranoia and delusions of control. Negative affect on awakening mediated a proportion of these relationships (range: 17.9-57.3%). For the first time, we show that sleep disturbance is a predictor of next-day impaired functioning and psychotic symptom severity in people with a diagnosis of schizophrenia. Therefore, interventions targeting sleep may have the potential to directly and indirectly enhance functional and symptomatic recovery in those experiencing psychosis.