The association between sleep disturbances and the at risk mental state: a systematic review

Poster B114, Tuesday, October 9, 11:30 am - 1:00 pm, Essex Ballroom

Latoya Clarke1,2, Katharine Chisholm2, Francesco Cappuccio1, Nicole Tang1, Farah Elahi1,3, Andrew Thompson1; 1University of Warwick, 2University of Birmingham, 3University of Nottingham

Background: Sleep disturbances are one of the most commonly reported symptoms proceeding the onset of frank psychosis. Yet, the relationship between specific sleep difficulties and early symptoms and functioning is still unclear. Aims: This review explores sleep quality, quantity and circadian rhythms and their associations with symptoms and functioning in Ultra High Risk (UHR) samples. A meta-analysis will be carried out if there is sufficient comparable data available. Methods: This review included a comprehensive search of six databases (including MEDLINE and PsycINFO) and hand searches of journals. Eligible studies included UHR individuals aged 16-35 years old. All studies provided data on sleep disturbances or disorders. Case studies and case reviews were excluded. Results: 5,960 studies were identified; 102 full texts were checked for eligibility. Fourteen studies met the inclusion criteria (total sample=1170 participants). UHR individuals experienced poorer sleep quality including reduced sleep efficiency, restless sleep and higher nightmare frequencies. Sleep quantity was reduced with increased movements, longer Wake After Sleep Onset and increased sleep latency in UHR groups compared to controls. Reduced Total Sleep Time was associated with positive symptoms. Studies reported a relationship between disrupted circadian rhythms (including sleep pattern disruption and day-night reversal) and positive symptoms. There were associations between sleep pattern and functioning cross-sectionally and longitudinally. Conclusions: There are distinct differences in how sleep quality, quantity and circadian rhythms relate to symptoms and functioning in UHR groups. Significant variations in how sleep is measured across studies highlights a need to assess sleep more consistently in UHR samples.

Topic Area: Ultra High Risk / Prodromal Research

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