Robbins Kate, Hodgekins Joanne, Reeve Sarah
Norwich Medical School, University of East Anglia, Norwich, UK.
Cambridgeshire and Peterborough NHS Foundation Trust, Cambridgeshire, UK.
Br J Clin Psychol. 2025 Apr 2. doi: 10.1111/bjc.12538.
There has been increasing attention to sleep disturbances such as insomnia in psychosis, due to its impact on symptoms, well-being, and recovery. However, excessive sleep and extended sleep duration are common in psychosis (partly linked to sedating antipsychotic medication) and have been relatively neglected, despite plausible interactions with symptoms, functioning, and broader well-being.
This study aimed to explore the experience of extended sleep duration and excessive sleepiness, or their combination (hypersomnia) in people with psychotic disorders through a qualitative interview around the experience, impacts, contributors, and role of treatment.
Ten patients experiencing excessive sleep (defined as excessive daytime sleepiness >3 days a week; extended sleep duration of > 11 h in 24 h or >9 h at night; or a combination of these) alongside a diagnosed psychotic disorder were recruited. They met with the researcher online to participate in a semi-structured interview, which was analysed using thematic analysis.
Five major themes were developed: (1) The Exhausting Everyday, (2) Medication is the story? (3) Indescribable Tiredness, (4) Overruled by Sleep and (5) An Unfair Fight. Excessive sleep impacts multiple domains of individual well-being and recovery - for example, limiting patients in everyday tasks and socializing. Cycles of emotional avoidance and inactivity were identified as potential maintainers or exacerbators of excessive sleep, in addition to medication side effects. Patients reported difficulty conveying the impact of their sleepiness symptoms to clinicians or others.
The results support that excessive sleep requires further attention as a problematic and impactful sleep presentation in this group. Further research is needed to improve recognition and assessment of problematic excessive sleep, and how existing practices or novel treatments may be applied to reduce its impact on recovery.
由于睡眠障碍如失眠对精神病症状、幸福感和康复有影响，其在精神病中越来越受到关注。然而，过度睡眠和延长睡眠时间在精神病中很常见（部分与镇静性抗精神病药物有关），尽管它们与症状、功能和更广泛的幸福感之间可能存在相互作用，但相对而言却被忽视了。
本研究旨在通过围绕经历、影响、促成因素和治疗作用进行定性访谈，探索精神病患者延长睡眠时间和过度嗜睡或两者结合（即嗜睡症）的体验。
招募了10名经历过度睡眠（定义为每周超过3天白天过度嗜睡；24小时内睡眠时间超过11小时或夜间睡眠时间超过9小时；或两者兼有）且患有已确诊精神病的患者。他们与研究人员进行在线会面，参与半结构化访谈，并采用主题分析法进行分析。
形成了五个主要主题：（1）疲惫的日常；（2）药物是原因吗？（3）难以言表的疲惫；（4）被睡眠支配；（5）一场不公平的斗争。过度睡眠会影响个人幸福感和康复的多个方面——例如，限制患者的日常任务和社交活动。除药物副作用外，情绪回避和不活动的循环被确定为过度睡眠的潜在维持因素或加重因素。患者报告称，难以向临床医生或其他人传达其嗜睡症状的影响。
研究结果支持，过度睡眠作为该群体中有问题且有影响的睡眠表现需要进一步关注。需要进一步研究以改善对有问题的过度睡眠的识别和评估，以及如何应用现有做法或新的治疗方法来减少其对康复的影响。
