Nina Zaks1, Tjasa Velikonja1,2, Muhammad A Parvaz1,3, Jamie Zinberg4, Monica Done4, Daniel H Mathalon5,6, Jean Addington7, Kristin Cadenhead8, Tyrone Cannon9, Barbara Cornblatt10,11, Thomas McGlashan9, Diana Perkins12, William S Stone13, Ming Tsuang8, Elaine Walker14, Scott W Woods9, Matcheri S Keshavan13, Daniel J Buysse15, Eva Velthorst1,16, Carrie E Bearden4,17. 1. Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA. 2. Evidence Based Practice Unit, Anna Freud National Centre for Children and Families, London, UK. 3. Department of Neuroscience, Icahn School of Medicine, Mount Sinai, NY, USA. 4. Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA. 5. San Francisco VA Health Care System. 6. University of California, San Francisco, CA, USA. 7. Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada. 8. Department of Psychiatry, University of California San Diego (UCSD), La Jolla, CA, USA. 9. Departments of Psychiatry and Psychology, Yale University, New Haven, CT, USA. 10. Department of Psychology, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA. 11. Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, and Feinstein Institute for Medical Research, Garden City, NY, USA. 12. Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA. 13. Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA. 14. Department of Psychology, Emory University, Atlanta, Georgia, USA. 15. University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 16. Seaver Center of Research and Treatment, Icahn School of Medicine, Mount Sinai, NY, USA. 17. Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
Abstract
INTRODUCTION: Disturbed sleep is a common feature of psychotic disorders that is also present in the clinical high risk (CHR) state. Evidence suggests a potential role of sleep disturbance in symptom progression, yet the interrelationship between sleep and CHR symptoms remains to be determined. To address this knowledge gap, we examined the association between disturbed sleep and CHR symptoms over time. METHODS: Data were obtained from the North American Prodrome Longitudinal Study (NAPLS)-3 consortium, including 688 CHR individuals and 94 controls (mean age 18.25, 46% female) for whom sleep was tracked prospectively for 8 months. We used Cox regression analyses to investigate whether sleep disturbances predicted conversion to psychosis up to >2 years later. With regressions and cross-lagged panel models, we analyzed longitudinal and bidirectional associations between sleep (the Pittsburgh Sleep Quality Index in conjunction with additional sleep items) and CHR symptoms. We also investigated the independent contribution of individual sleep characteristics on CHR symptom domains separately and explored whether cognitive impairments, stress, depression, and psychotropic medication affected the associations. RESULTS: Disturbed sleep at baseline did not predict conversion to psychosis. However, sleep disturbance was strongly correlated with heightened CHR symptoms over time. Depression accounted for half of the association between sleep and symptoms. Importantly, sleep was a significant predictor of CHR symptoms but not vice versa, although bidirectional effect sizes were similar. DISCUSSION: The critical role of sleep disturbance in CHR symptom changes suggests that sleep may be a promising intervention target to moderate outcome in the CHR state.
INTRODUCTION: Disturbed sleep is a common feature of psychotic disorders that is also present in the clinical high risk (CHR) state. Evidence suggests a potential role of sleep disturbance in symptom progression, yet the interrelationship between sleep and CHR symptoms remains to be determined. To address this knowledge gap, we examined the association between disturbed sleep and CHR symptoms over time. METHODS: Data were obtained from the North American Prodrome Longitudinal Study (NAPLS)-3 consortium, including 688 CHR individuals and 94 controls (mean age 18.25, 46% female) for whom sleep was tracked prospectively for 8 months. We used Cox regression analyses to investigate whether sleep disturbances predicted conversion to psychosis up to >2 years later. With regressions and cross-lagged panel models, we analyzed longitudinal and bidirectional associations between sleep (the Pittsburgh Sleep Quality Index in conjunction with additional sleep items) and CHR symptoms. We also investigated the independent contribution of individual sleep characteristics on CHR symptom domains separately and explored whether cognitive impairments, stress, depression, and psychotropic medication affected the associations. RESULTS: Disturbed sleep at baseline did not predict conversion to psychosis. However, sleep disturbance was strongly correlated with heightened CHR symptoms over time. Depression accounted for half of the association between sleep and symptoms. Importantly, sleep was a significant predictor of CHR symptoms but not vice versa, although bidirectional effect sizes were similar. DISCUSSION: The critical role of sleep disturbance in CHR symptom changes suggests that sleep may be a promising intervention target to moderate outcome in the CHR state.
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Authors: Emily R Kline; Larry J Seidman; Barbara A Cornblatt; Kristen A Woodberry; Caitlin Bryant; Carrie E Bearden; Kristin S Cadenhead; Tyrone D Cannon; Daniel H Mathalon; Thomas H McGlashan; Diana O Perkins; Ming T Tsuang; Elaine F Walker; Scott W Woods; Jean Addington Journal: Schizophr Res Date: 2017-06-01 Impact factor: 4.939
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Authors: Kathleen P O'Hora; Zizhao Zhang; Ariana Vajdi; Leila Kushan-Wells; Zhengyi Sissi Huang; Laura Pacheco-Hansen; Elizabeth Roof; Anthony Holland; Ruben C Gur; Carrie E Bearden Journal: Front Psychiatry Date: 2022-04-13 Impact factor: 5.435