The relationship between objective sleep variables and subjective sleep estimation in schizophrenia
01 Jan 2000-International Journal of Psychiatry in Clinical Practice (Taylor & Francis)-Vol. 4, Iss: 1, pp 63-67
TL;DR: A high positive correlation was shown between objective sleep latency and its subjective estimation; a positive correlation between subjective estimation of sleep depth and percentage of slow wave sleep; and a negative correlation between eye movement and wakefulness during the night.
Abstract: AIM: Few investigations of sleep structure in schizophrenia have concentrated on the relationship between objective and subjective sleep variables. The aim of this study was to assess objective sleep variables and subjective estimation of sleep duration and sleep quality. METHODS: Polysomnography was performed in 20 chronic patients with schizophrenia during three consecutive nights. After final awakenings subjects answered questions concerning subjective estimations of sleep duration, sleep latency, number of awakenings, and sleep depth. Pearson correlations between ranged subjective reports and objective sleep variables were performed. RESULTS: The results showed a high positive correlation between objective sleep latency and its subjective estimation; a positive correlation between subjective estimation of sleep depth and percentage of slow wave sleep (SWS%); a positive correlation between eye movement (EM) density and subjective estimation of wakefulness during the night; and a negative correlation be...
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TL;DR: The results are consistent with the hypotheses that poor sleep may play a unique role in sustaining poor quality of life and impaired coping in patients with schizophrenia and these associations may hold for community controls as well.
Abstract: While sleep disturbance is widespread in schizophrenia it is less clear whether sleep disturbance is uniquely related to impaired coping and perceived quality of life. We simultaneously assessed sleep quality, symptoms, and coping in 29 persons with schizophrenia or schizoaffective disorder in a post acute phase of illness. Assessment instruments included the Pittsburgh Sleep Quality Index; the Positive and Negative Symptom Scale; the Heinrichs Quality of Life Scale; and the Ways of Coping Scale. Multiple regressions were performed predicting quality of life and coping from sleep quality controlling for age and symptom severity. On a subset of seven subjects non-dominant wrist actigraphy was used as an objective check of their self-reported poor sleep. Analyses revealed that poor sleep quality predicted low quality of life (r = -0.493; p = .022) and reduced preference for employing positive reappraisal when facing a stressor (r = -0.0594; p = 0.0012). Actigraphy confirmed poor sleep quality in a subset of subjects. They had shorter sleep duration (p < .0005), shorter average sleep episodes (p < .005) and more episodes of long awakening (p < 0.05) than community norms. The results are consistent with the hypotheses that poor sleep may play a unique role in sustaining poor quality of life and impaired coping in patients with schizophrenia. These associations may hold for community controls as well.
137 citations
TL;DR: This paper examined the role of attachment insecurity in sleep problems among married adults (N=78 couples) and found that attachment anxiety was associated with higher levels of self-reported sleep difficulties for men and women, whereas attachment avoidance was not.
Abstract: This study examined the role of attachment insecurity in sleep problems among married adults (N=78 couples). Using the Pittsburgh Sleep Quality Index and structural equation modeling, attachment anxiety was associated with higher levels of self-reported sleep difficulties for men and women, whereas attachment avoidance was not. Depressed affect was included as a control variable, and the effect of attachment anxiety remained significant. Men and women did not differ significantly in the magnitude of the effect of attachment anxiety on sleep quality. In addition, there were no cross-partner effects of attachment insecurity on sleep quality or depressed affect. Implications and future directions are discussed.
93 citations
TL;DR: Slow wave sleep in depression has a positive influence on the subjective feeling of sleep duration while phasic REM sleep activity has a negative influence.
82 citations
TL;DR: The sleep and circadian rhythm disruption of older schizophrenia patients was more extensive than that of matched NCS suggesting patients' sleep disruption was above and beyond what is attributable to advanced age alone.
77 citations
Cites background from "The relationship between objective ..."
...Individuals with schizophrenia commonly complain of disturbed nighttime sleep both in inpatient (Morgan and Drew, 1970; Rotenberg et al., 2000) and outpatient settings (Haffmans et al., 1994; Sweetwood et al., 1976)....
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TL;DR: The results suggest that the T3111C polymorphism of the CLOCK gene is associated with schizophrenia.
75 citations
Cites background from "The relationship between objective ..."
...It is well known that individuals with schizophrenia often develop disturbed nighttime sleep in addition to so-called positive and negative symptoms (Rotenberg et al., 2000)....
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References
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TL;DR: Review of five studies involving the PANSS provided evidence of its criterion-related validity with antecedent, genealogical, and concurrent measures, its predictive validity, its drug sensitivity, and its utility for both typological and dimensional assessment.
Abstract: The variable results of positive-negative research with schizophrenics underscore the importance of well-characterized, standardized measurement techniques. We report on the development and initial standardization of the Positive and Negative Syndrome Scale (PANSS) for typological and dimensional assessment. Based on two established psychiatric rating systems, the 30-item PANSS was conceived as an operationalized, drug-sensitive instrument that provides balanced representation of positive and negative symptoms and gauges their relationship to one another and to global psychopathology. It thus constitutes four scales measuring positive and negative syndromes, their differential, and general severity of illness. Study of 101 schizophrenics found the four scales to be normally distributed and supported their reliability and stability. Positive and negative scores were inversely correlated once their common association with general psychopathology was extracted, suggesting that they represent mutually exclusive constructs. Review of five studies involving the PANSS provided evidence of its criterion-related validity with antecedent, genealogical, and concurrent measures, its predictive validity, its drug sensitivity, and its utility for both typological and dimensional assessment.
18,358 citations
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01 Jan 1968
11,993 citations
TL;DR: Electroencephalographic sleep in drug-naive and previously medicated schizophrenics had significantly greater impairment of sleep continuity and shorter rapid eye movement latency when compared with controls, and findings were significantly influenced by duration of drug-free status.
Abstract: Polysomnographic abnormalities in schizophrenia are not well characterized and their associations with schizophrenic symptomatology have not been adequately assessed. To address these issues, we recorded electroencephalographic sleep in 20 drug-naive schizophrenics, 20 drug-free but previously medicated schizophrenics, and 15 normal controls. Drug-naive and previously medicated patients had significantly greater impairment of sleep continuity and shorter rapid eye movement latency when compared with controls. In the previously medicated group, findings were significantly influenced by duration of drug-free status. Rapid eye movement latency was inversely correlated with the severity of negative symptoms (r = -.52) but was unrelated to depressive symptoms. Slow-wave sleep did not differ between schizophrenic patients and normal controls and was unrelated to any clinical parameter. Mechanisms underlying the observed associations between rapid eye movement sleep abnormalities and negative symptoms in the acute phase of schizophrenic illness need to be explored.
197 citations
TL;DR: The results indicate that the duration of wakefulness prior to sleep and the timing of sleep determine its physiological expression, which in turn determines its subjective impression.
Abstract: SUMMARY The present study used short sleep episodes to explore the relation between subjective sleep quality, timing and physiological content of sleep. Eight subjects participated in 18 4-h sleep episodes to provide 4, 8, and 12 h of prior time awake before bedtimes at six different times of day in a sleep laboratory insulated from environmental disturbances. The results were analysed by ANOVAs and multiple regression techniques. Subjective sleep quality, calmness of sleep, ease of falling asleep, ability to ‘sleep through’, number of awakenings, and sleep latency showed a significant pattern of ‘better’ sleep with increasing prior time awake and with closeness to the circadian minimum (nadir) of rectal temperature (morning hours). ‘Ease of awakening’ in contrast, ‘decreased’ with increasing time awake and with closeness to the nadir/ morning hours. Multiple regression analysis showed that subjective sleep quality was predicted by subjective calmness of sleep and ease of falling asleep, among the subjective measures, and by total sleep time (TST) and slow-wave sleep (SWS – stages 3 +4) among the physiological sleep measures. The subjective ease of awakening was predicted by slow-wave sleep (negatively) and the circadian maximum of rectal temperature. The results indicate that the duration of wakefulness prior to sleep and the timing of sleep determine its physiological expression, which in turn determines its subjective impression.
166 citations
TL;DR: Ten insomniacs and matched control subjects, in whom major physiologic disorders such as sleep apnea and nocturnal myoclonus were ruled out, underwent studies of sleep, temperature, motor activity, cognitive performance, and perception of depth of sleep.
Abstract: Ten insomniacs and matched control subjects, in whom major physiologic disorders such as sleep apnea and nocturnal myoclonus were ruled out, underwent studies of sleep, temperature, motor activity, cognitive performance, and perception of depth of sleep. Subjective descriptions of sleep differed significantly between insomniacs and normals on a variety of variables. In contrast, polysomnographic evaluation showed increased intermittent waking time and decreased sleep efficiency, and only a tendency toward decreased total sleep and increased sleep latency. Minnesota Multiphasic Personality Inventory (MMPI) evaluation revealed that insomniacs had higher scores on the F,D, and SI scales, and lower values on the K scale. On cognitive testing, insomniacs did well on tests of episodic (recent) memory, but displayed major deficits in accessing semantic memory (retrieval of material already known). Compared to normals, insomniacs described rapid eye movement (REM) sleep as relatively “light” sleep.
157 citations