Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Adult Psychiatry Department, Grenoble Institut Neurosciences, 38000 Grenoble, France.
Univ. Grenoble Alpes, CHU Grenoble Alpes, Adult Psychiatry Department, 38000 Grenoble, France.
Aust N Z J Psychiatry. 2022 Sep;56(9):1068-1079. doi: 10.1177/00048674211068395. Epub 2021 Dec 31.
To provide a qualitative view and quantitative measure of sleep disturbances across and between early stages - clinical ultra high-risk and first episode - of psychotic and bipolar disorders.
Electronic databases (PubMed, Cochrane, Embase, PsychINFO) were searched up to March 2021 for studies comparing sleep measures between individuals with an early stage and controls. Standard mean deviations (Cohen's effect sizes) were calculated for all comparisons and pooled with random-effects models. Chi-square tests were used for direct between-subgroups (ultra high-risk vs first episode) comparisons of standard mean deviations. The effects of age, sex ratio, symptoms and treatment were examined in meta-regression analyses.
A database search identified 13 studies that contrasted sleep measures between individuals with an early stage ( = 537) and controls ( = 360). We observed poorer subjective sleep quality (standard mean deviation = 1.32; 95% confidence interval, [1.01, 1.62]), shorter total sleep time (standard mean deviation =-0.44; 95% confidence interval, [-0.67, -0.21]), lower sleep efficiency (standard mean deviation = -0.72; 95% confidence interval, [-1.08, -0.36]), longer sleep onset latency (standard mean deviation = 0.75; 95% confidence interval, [0.45, 1.06]) and longer duration of wake after sleep onset (standard mean deviation = 0.49; 95% confidence interval, [0.21, 0.77]) were observed in early stages compared to controls. No significant differences were observed for any of the reported electroencephalographic parameters of sleep architecture. No significant between-subgroups differences were observed. Meta-regressions revealed a significant effect of the age and the antipsychotic status on subjective measures of sleep.
The early stage population presents with significant impairments of subjective sleep quality continuity, duration and initiation. Systematic assessments of sleep in early intervention settings may allow early identification and treatment of sleep disturbances in this population.
提供精神分裂症和双相障碍早期阶段（临床超高危和首发）的睡眠障碍的定性观察和定量测量。
截至 2021 年 3 月，我们在电子数据库（PubMed、Cochrane、Embase、PsychINFO）中搜索了比较早期阶段个体与对照组之间睡眠测量的研究。为所有比较计算了标准均数差值（Cohen 的效应量），并采用随机效应模型进行了汇总。采用卡方检验对超高危与首发之间的亚组间（直接）进行标准均数差值比较。在元回归分析中检查了年龄、性别比、症状和治疗的影响。
数据库搜索确定了 13 项比较早期阶段个体（ = 537）与对照组（ = 360）之间睡眠测量的研究。我们观察到较差的主观睡眠质量（标准均数差值 = 1.32；95%置信区间 [1.01, 1.62]）、总睡眠时间更短（标准均数差值 =-0.44；95%置信区间 [-0.67, -0.21]）、睡眠效率更低（标准均数差值 =-0.72；95%置信区间 [-1.08, -0.36]）、入睡潜伏期更长（标准均数差值 = 0.75；95%置信区间 [0.45, 1.06]）和睡眠后觉醒时间更长（标准均数差值 = 0.49；95%置信区间 [0.21, 0.77]），与对照组相比，这些都是早期阶段的特征。睡眠结构的任何报告的脑电图参数均未见显著差异。亚组间无显著差异。元回归显示年龄和抗精神病药物状态对睡眠主观测量有显著影响。
早期阶段人群的主观睡眠质量连续性、持续时间和启动均存在显著障碍。在早期干预环境中对睡眠进行系统评估可能会允许早期识别和治疗该人群的睡眠障碍。
Zotero 插件