Jan Cosgrave1,2, Katharina Wulff2, Philip Gehrman1. 1. Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 2. Nuffield Department of Clinical Neurosciences, Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK.
Abstract
PURPOSE OF REVIEW: The review is designed to give an overview of the latest developments in research exploring the relationship between sleep and psychosis, with particular attention paid to the evidence for a causal relationship between the two. RECENT FINDINGS: The most interesting avenues currently in pursuit are focused upon sleep spindle deficits which may hallmark an endophenotype; explorations of the continuum of psychotic experiences, and experimental manipulations to explore the evidence for bidirectional causality; inflammatory markers, psychosis and sleep disturbances and finally, treatment approaches for sleep in psychosis and the subsequent impact on positive experiences. SUMMARY: Globally, large surveys and tightly controlled sleep deprivation or manipulation experiments provide good evidence for a cause-and-effect relationship between sleep and subclinical psychotic experiences. The evidence for cause-and-effect using a interventionist-causal model is more ambiguous; it would appear treating insomnia improves psychotic experiences in an insomnia cohort but not in a cohort with schizophrenia. This advocates the necessity for mechanism-driven research with dimensional approaches and in depth phenotyping of circadian clock-driven processes and sleep regulating functions. Such an approach would lead to greater insight into the dynamics of sleep changes in healthy and acute psychosis brain states.
PURPOSE OF REVIEW: The review is designed to give an overview of the latest developments in research exploring the relationship between sleep and psychosis, with particular attention paid to the evidence for a causal relationship between the two. RECENT FINDINGS: The most interesting avenues currently in pursuit are focused upon sleep spindle deficits which may hallmark an endophenotype; explorations of the continuum of psychotic experiences, and experimental manipulations to explore the evidence for bidirectional causality; inflammatory markers, psychosis and sleep disturbances and finally, treatment approaches for sleep in psychosis and the subsequent impact on positive experiences. SUMMARY: Globally, large surveys and tightly controlled sleep deprivation or manipulation experiments provide good evidence for a cause-and-effect relationship between sleep and subclinical psychotic experiences. The evidence for cause-and-effect using a interventionist-causal model is more ambiguous; it would appear treating insomnia improves psychotic experiences in an insomnia cohort but not in a cohort with schizophrenia. This advocates the necessity for mechanism-driven research with dimensional approaches and in depth phenotyping of circadian clock-driven processes and sleep regulating functions. Such an approach would lead to greater insight into the dynamics of sleep changes in healthy and acute psychosis brain states.
Authors: Laura Palagini; Raffaele Manni; Eugenio Aguglia; Mario Amore; Roberto Brugnoli; Paolo Girardi; Luigi Grassi; Claudio Mencacci; Giuseppe Plazzi; Antonino Minervino; Lino Nobili; Giovanni Biggio Journal: Front Psychiatry Date: 2020-06-26 Impact factor: 4.157
Authors: Jessica L Obeysekare; Zachary L Cohen; Meredith E Coles; Teri B Pearlstein; Carmen Monzon; E Ellen Flynn; Katherine M Sharkey Journal: Transl Psychiatry Date: 2020-01-21 Impact factor: 6.222