Researchers from the University of Pittsburgh and Italy discovered common patterns of sleep abnormalities and irregularities in the daily rhythm of rest and activity in patients with schizophrenia spectrum disorder, or SSD.
The findings were published in Molecular Psychiatry.
The researchers found that both individuals with SSD who resided in psychiatric hospitals and those who managed their condition in outpatient settings had sleep patterns, irregular transitions between sleep and wake cycles, and highly rigid daily routines that were predictive of worse SSD symptoms and were associated with Quality of life.
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“Regulating your sleep-wake cycle is important to your overall health and our findings can be extended to people without underlying mental health conditions,” said Fabio Ferrarelli, MD, PhD, associate professor of psychiatry and senior author of the study. “Most people can benefit from good sleep hygiene and focus on their daily routine by incorporating activity and variety into their daily lives.”
The effects of disrupted sleep have long been studied in terms of physical and mental health, and well-established research literature suggests that people suffering from SSD have trouble sleeping and have poorer rest than people without an underlying mental health condition.
Additionally, sedatives used to manage SSD symptoms are known to alter sleep and extend the amount of time patients rest by up to 15 hours per day. Too much sleep can have negative consequences on patients’ SSD symptoms, Ferrarili says.
“It’s important to consider how the drugs we prescribe to patients affect their health more broadly,” he said. “Our study shows that 12 to 15 hours of sleep can be harmful, and it’s important to avoid excessive sleep and use the lowest possible dose.”
In a study of 250 participants, approximately 150 inpatient and outpatient SSD patients representing one of the largest cohorts of published studies on sleep and SSD, researchers measured participants’ activity and rest throughout the day and night. Detects movement and acceleration.
The scientists did not track brain waves during sleep or distinguish between different stages of sleep — such as REM sleep and deep sleep — as they plan to do in future studies. Nevertheless, the results were strong and consistent.
They found that both residential and outpatient SSD individuals had fewer active hours during the day and spent more time sleeping or passively resting than healthy controls.
In addition, residential patients had more fragmented sleep and more abrupt transitions between rest and activity than the outpatient group. Residential patients also exhibited more rigid rhythms of daily rest and activity than outpatients, and those measures were associated with a greater degree of negative mental health symptoms, including less motivation to interact with others and less ability to feel pleasure.
“The consistency between the two patient cohorts was surprising to us,” Ferrarili said. “But, interestingly, we found very stable daily routines in residential patients. We think of stable routines as a good thing, but when these routines are too rigid, they can present a problem. In our study, this rigidity. Daily rhythms was associated with the severity of negative mental health symptoms in residential patients with schizophrenia.”
Researchers say it’s not possible to use markers of disrupted sleep to diagnose SSD because symptoms overlap with other mental health conditions, such as dementia. But changing your daily routine and incorporating movement into your life are two simple steps that everyone can take to improve and protect their brain health.
“Especially as people get older, we get deeper into our routines,” Ferrarili said. “Routines provide a sense of control over our lives and can be very beneficial. But if the routine is too rigid, it can backfire. Keeping your sleep schedule consistent by mixing up your daily tasks and dividing them into different days of the week will add variety to your schedule and improve your health long-term. It’s a good way to improve.”
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