Sleep disturbances in individuals with first episode psychosis and clinical high-risk states: A systematic review

Area of Science:

• Psychiatry
• Neuroscience
• Sleep Medicine

Background:

• Sleep disturbances are integral to psychosis, appearing early and persisting.
• First-episode psychosis (FEP) patients exhibit altered sleep architecture, including reduced efficiency and increased latency.
• Clinical High-Risk (CHR) individuals also show sleep abnormalities linked to cognitive and affective deficits.

Purpose of the Study:

• To systematically review sleep disturbances in first-episode psychosis (FEP) and Clinical High-Risk (CHR) populations.
• To compare sleep parameters in FEP and CHR individuals with healthy controls.
• To understand the relationship between sleep abnormalities and clinical/cognitive impairments in early psychosis.

Main Methods:

• Systematic literature search across PubMed, Web of Science, EMBASE, and PsycINFO.
• Inclusion of studies with quantitative and qualitative sleep assessments in FEP and CHR subjects.
• Comparison of sleep data from 1255 patients across 25 studies against 342 healthy controls.

Main Results:

• Increased sleep latency and altered slow-wave sleep were frequently observed in FEP and CHR individuals.
• Sleep disturbances are pervasive in early psychosis, with potential bidirectional links to psychotic symptoms.
• Sleep disruptions may worsen cognitive and emotional dysfunction in these populations.

Conclusions:

• Pervasive sleep disturbances in FEP/CHR populations may indicate underlying psychosis-related neurobiology.
• Sleep abnormalities are potential modifiable targets for early intervention in psychosis.
• Further research is needed on longitudinal associations and sleep interventions for early psychosis.