Oxford Institute of Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust, Warneford Hospital, Warneford Lane, Oxford OX3 7JX, United Kingdom.
Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge CB21 5EF, United Kingdom.
Clin Psychol Rev. 2024 Dec;114:102503. doi: 10.1016/j.cpr.2024.102503. Epub 2024 Sep 18.
Sleep dysfunction commonly co-occurs with paranoia and is hypothesised to be a contributory causal mechanism in its development and maintenance.
To systematically review and quantitatively evaluate the evidence for the relationship between sleep dysfunction and paranoia across the spectrum of severity.
A systematic search was conducted to identify studies investigating the relationship between aspects of sleep and paranoia across clinical and non-clinical groups. A random effects model using a Fisher r-to-z transformed correlation coefficient was used for meta-analysis.
45 studies were included in the review and 14 in the meta-analysis. The literature supports a small-to-moderate association (r = 0.30, 95 % CI: 0.16-0.40 for the seven studies using the most robust measures) with significant heterogeneity among studies but no evidence of publication bias. There is evidence that the relationship is to some extent causal, with sleep disruption leading to increased paranoia, though there is also some evidence of a bi-directional relationship. Negative affect is frequently seen as a mediator of this relationship.
This review for the first time examines the significant relationship between sleep and paranoia individually. Studies are needed that further assess the potential for early intervention of sleep dysfunction in those experiencing paranoia.
睡眠功能障碍通常与妄想共现，并被假设为其发展和维持的促成因果机制。
系统回顾并定量评估睡眠功能障碍与妄想在整个严重程度范围内的关系的证据。
进行了系统搜索，以确定研究睡眠各个方面与临床和非临床人群中妄想之间关系的研究。使用 Fisher r 到 z 转换相关系数的随机效应模型用于荟萃分析。
综述纳入了 45 项研究，荟萃分析纳入了 14 项研究。文献支持存在小到中度关联（使用最可靠测量方法的七项研究的 r=0.30，95%置信区间：0.16-0.40），但研究之间存在显著异质性，且无发表偏倚的证据。有证据表明，这种关系在某种程度上是因果关系，睡眠中断会导致妄想增加，但也有一些证据表明存在双向关系。负面情绪经常被视为这种关系的中介。
本综述首次单独检查了睡眠与妄想之间的显著关系。需要进行进一步研究，以评估在出现妄想的人群中早期干预睡眠功能障碍的潜力。
