Individuals with schizophrenia experience extreme disruptions in their sleeping patterns, according to a new Oxford-led study
Half also have irregular body clocks out of sync with the pattern of night and day.
Twenty patients with schizophrenia were involved in the research. Severe disruption in the sleep patterns were found in all 20 patients, despite their mood being stable and each being on a steady drug regime.
All patients took longer to fall asleep, spent longer in bed, slept longer and had much more variable sleep patterns, compared with a control group of 21 healthy unemployed people.
The research team insists that the severe impact of these long-term sleep disturbances need to be considered during treatment along with the other symptoms of schizophrenia, because they have such a strong effect on mood, social function, mental abilities and quality of life.
“The people in our study were stable in mood, taking medication and yet they still experienced enormous sleep problems,” says first author Dr. Katharina Wulff of the Nuffield Department of Clinical Neurosciences at the University of Oxford.
“Clinicians may need to start thinking about treating their patients’ sleep problems as well, or refer them to sleep specialists,” she says.
The variable sleep patterns are unlikely to be simply caused by having unstructured days without any routine, since those in the control group may also not have a pattern to their daily lives. The sleep disturbances also appeared unrelated to the different drugs taken by those with schizophrenia.
Ten of the patients also had irregular body clocks: Their internal 24-hour rhythm was delayed compared with all the others, or longer than 24 hours. They were often sleeping at times other than at night.
For example, an individual may only fall asleep after 4 a.m. and get up in the afternoon or have ‘free-running’ sleep patterns unrelated to the 24-hour day.
Although the study provides strong evidence of an association between schizophrenia and severely disrupted sleep patterns, there is not yet a demonstrated causal link between the two.
Sleep disturbances are considered common in many mental health disorders, including schizophrenia. However, this is one of the first studies to provide solid evidence as well as look for body clock abnormalities.
“Patients often complain of being so tired they can’t concentrate, can’t work, that dealing with their sleep problems would make life so much better. There are also lots of anecdotal stories from psychiatrists of patients being unable to settle to sleep and running around all night, or not turning up to consultations organized for mornings,” says Professor Russell Foster of Oxford University, who headed the research group.
“We now know many of the patients are also essentially suffering persistent jetlag with their body clocks out of synch with day and night. This immediately opens up a lot of new avenues for research in understanding the links between sleep problems and mental ill health.
“But regardless of whether or not there is a mechanistic link between the body clock and psychiatric conditions, it is clear that treating sleep problems could improve the lives of many patients.’
The Oxford University-led study, with colleagues from UCL and the University of Surrey, is published online by the British Journal of Psychiatry.
Source: University of Oxford