Sleep disturbances in early clinical stages of psychotic and bipolar disorders: A meta-analysis.
Aust N Z J Psychiatry
; 56(9): 1068-1079, 2022 09.
Article
em En
| MEDLINE
| ID: mdl-34971518
ABSTRACT
OBJECTIVE:
To provide a qualitative view and quantitative measure of sleep disturbances across and between early stages - clinical ultra high-risk and first episode - of psychotic and bipolar disorders.METHODS:
Electronic databases (PubMed, Cochrane, Embase, PsychINFO) were searched up to March 2021 for studies comparing sleep measures between individuals with an early stage and controls. Standard mean deviations (Cohen's d effect sizes) were calculated for all comparisons and pooled with random-effects models. Chi-square tests were used for direct between-subgroups (ultra high-risk vs first episode) comparisons of standard mean deviations. The effects of age, sex ratio, symptoms and treatment were examined in meta-regression analyses.RESULTS:
A database search identified 13 studies that contrasted sleep measures between individuals with an early stage (N = 537) and controls (N = 360). We observed poorer subjective sleep quality (standard mean deviation = 1.32; 95% confidence interval, [1.01, 1.62]), shorter total sleep time (standard mean deviation =-0.44; 95% confidence interval, [-0.67, -0.21]), lower sleep efficiency (standard mean deviation = -0.72; 95% confidence interval, [-1.08, -0.36]), longer sleep onset latency (standard mean deviation = 0.75; 95% confidence interval, [0.45, 1.06]) and longer duration of wake after sleep onset (standard mean deviation = 0.49; 95% confidence interval, [0.21, 0.77]) were observed in early stages compared to controls. No significant differences were observed for any of the reported electroencephalographic parameters of sleep architecture. No significant between-subgroups differences were observed. Meta-regressions revealed a significant effect of the age and the antipsychotic status on subjective measures of sleep.CONCLUSION:
The early stage population presents with significant impairments of subjective sleep quality continuity, duration and initiation. Systematic assessments of sleep in early intervention settings may allow early identification and treatment of sleep disturbances in this population.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transtornos do Sono-Vigília
/
Transtorno Bipolar
/
Distúrbios do Início e da Manutenção do Sono
Tipo de estudo:
Prognostic_studies
/
Qualitative_research
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Aust N Z J Psychiatry
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
França