• Posted April 17, 2023

Regular Sleep May Be Crucial for People Living With Schizophrenia

Consistently good sleep is important for everyone, but it is particularly important for patients with schizophrenia, a new study suggests.

Researchers from the University of Pittsburgh, along with collaborators in Italy, used wrist monitors to measure activity and rest in 250 people, including 150 patients with schizophrenia, in both outpatient settings and in psychiatric hospitals.

The investigators found that the schizophrenia patients had erratic sleep patterns, dysregulated transitions between sleep and wake cycles, and excessively rigid daily routines that were predictive of worse symptoms.

"Regulating sleep and wake cycles is important for your overall health and our findings can also be extended to people without underlying mental health conditions,"said senior study author Dr. Fabio Ferrarelli, an associate professor of psychiatry at Pitt. "Most people can benefit from better sleep hygiene and paying attention to their daily routines by incorporating activity and variety in their daily lives."

Well-established research literature suggests that people suffering from schizophrenia have trouble falling asleep and get poorer rest than people without mental health conditions.

Sedatives used to manage schizophrenia symptoms can extend sleep to 15 hours per day. Getting too much sleep like this can have a negative effect on symptoms.

"It's important to be mindful of how drugs that we prescribe to patients affect their health more broadly,"Ferrarelli said in a Pitt news release. "Our study shows that a 12- to 15-hour sleep can be harmful, and it's important to avoid overprescribing sedatives and use the lowest dose possible."

Both inpatient and outpatient schizophrenia patients tended to have fewer active hours during the day and spent more time sleeping or passively resting than the study's healthy controls, the findings showed.

Inpatients had more fragmented sleep and more abrupt transitions between rest and activity compared to the outpatient group. They also had more rigid rhythms of daily rest and activity than outpatients. That correlated with a greater degree of negative mental health symptoms in these patients, including reduced motivation to interact with others and blunted capacity for feeling pleasure.

"The consistency between the two patient cohorts was somewhat surprising to us,"Ferrarelli said. "But, interestingly, we found that residential patients had much more stable daily routines. We tend to think of stable routines as a good thing, but when these routines become too rigid, they can present a problem. In our study, this rigidity in daily rhythms was strongly correlated to the severity of negative mental health symptoms in residential patients with schizophrenia."

The findings were published April 14 in the journal Molecular Psychiatry. This research was supported by the U.S. National Institute of Mental Health.

The researchers suggested that varying your daily routines and incorporating movement into your life are two simple steps that everyone can take to improve and protect their brain health.

"Especially as people get older, we tend to get deep into our routines,"said Ferrarelli. "Routines provide a sense of control to our lives and can be very beneficial. But if a routine is too rigid, it can backfire. Keeping your sleep schedule consistent while mixing up your daily tasks and splitting them across different days of the week is a good way to add variety to your schedule and improve your health long-term."

More information

The U.S. National Institute of Mental Health has more on schizophrenia.

SOURCE: University of Pittsburgh, news release, April 14, 2023