Cederlöf Erik, Holm Minna, Kämpe Anders, Ahola-Olli Ari, Kantojärvi Katri, Lähteenvuo Markku, Ahti Johan, Hietala Jarmo, Häkkinen Katja, Isometsä Erkki, Tuulio-Henriksson Annamari, Kampman Olli, Lahdensuo Kaisla, Lönnqvist Jouko, Tiihonen Jari, Turunen Hannu, Wegelius Asko, Veijola Juha, Kieseppä Tuula, Palotie Aarno, Paunio Tiina
Finnish Institute for Health and Welfare, Helsinki, Finland.
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Psychol Med. 2025 Apr 15;55:e117. doi: 10.1017/S0033291725000844.
Sleep problems are common in psychotic disorders and are associated with worse quality of life and disease prognosis. Genome-wide association studies (GWAS) have revealed genetic influences for schizophrenia and sleep, but polygenic scores (PGSs) for sleep traits have not been evaluated systematically in patients with psychotic disorders.
This study investigated the associations between PGSs for sleep traits (insomnia, PGS; sleep duration, PGS; short sleep duration, PGS; long sleep duration; PGS), diurnal preference (eveningness, PGS), and schizophrenia (PGS) with clinical features of psychotic disorders in the Finnish SUPER study comprising 8,232 patients with psychotic disorders. The measures included self-reported sleep and well-being, cognitive assessments, clozapine use, and functional outcomes. Using FinnGen data of 356,077 individuals, we analyzed the distributions of PGSs in psychotic and bipolar disorders and the general population.
PGS associated with more sleep problems and worse well-being (e.g. worse health-related quality of life [β = -0.07, CI = -0.09, -0.05, < .001]). High PGS is associated with better sleep quality, worse clinical outcomes, and performance in cognitive tests (e.g. more errors in paired-associated learning [β = 0.07, CI = 0.04, 0.09, < .001]). PGS was higher in affective psychotic and bipolar disorders, while PGS and PGS were higher in schizophrenia as compared with individuals with no psychiatric disorders.
Genetic risks for sleep and diurnal preference vary between non-affective psychosis, affective psychosis, and the general population. The findings in this study emphasize the heterogeneity in genetic etiology of the objective features of disease severity and the more subjective measures related to well-being and self-reported measures of sleep.
睡眠问题在精神障碍中很常见，并且与较差的生活质量和疾病预后相关。全基因组关联研究（GWAS）已经揭示了精神分裂症和睡眠的遗传影响，但睡眠特征的多基因评分（PGS）尚未在精神障碍患者中进行系统评估。
本研究在芬兰的SUPER研究中调查了睡眠特征（失眠，PGS；睡眠时间，PGS；短睡眠时间，PGS；长睡眠时间；PGS）、昼夜偏好（夜型，PGS）和精神分裂症（PGS）的PGS与8232例精神障碍患者的精神障碍临床特征之间的关联。测量指标包括自我报告的睡眠和幸福感、认知评估、氯氮平使用情况和功能结局。利用356,077人的芬兰基因数据，我们分析了PGS在精神障碍、双相情感障碍和普通人群中的分布情况。
PGS与更多的睡眠问题和更差的幸福感相关（例如，与健康相关的生活质量更差[β = -0.07，CI = -0.09，-0.05，<0.001]）。高PGS与更好的睡眠质量、更差的临床结局以及认知测试中的表现相关（例如，配对联想学习中的错误更多[β = 0.07，CI = 0.04，0.09，<0.001]）。与无精神障碍的个体相比，情感性精神病和双相情感障碍患者的PGS更高，而精神分裂症患者的PGS和PGS更高。
睡眠和昼夜偏好的遗传风险在非情感性精神病、情感性精神病和普通人群之间存在差异。本研究结果强调了疾病严重程度客观特征以及与幸福感和自我报告睡眠相关的更主观测量指标的遗传病因中的异质性。
