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Sleep and circadian rhythm disruption in schizophrenia

  • Katharina Wulff (a1), Derk-Jan Dijk (a2), Benita Middleton (a2), Russell G. Foster (a1) and Eileen M. Joyce (a3)...
Abstract
Background

Sleep disturbances comparable with insomnia occur in up to 80% of people with schizophrenia, but very little is known about the contribution of circadian coordination to these prevalent disruptions.

Aims

A systematic exploration of circadian time patterns in individuals with schizophrenia with recurrent sleep disruption.

Method

We examined the relationship between sleep–wake activity, recorded actigraphically over 6 weeks, along with ambient light exposure and simultaneous circadian clock timing, by collecting weekly 48 h profiles of a urinary metabolite of melatonin in 20 out-patients with schizophrenia and 21 healthy control individuals matched for age, gender and being unemployed.

Results

Significant sleep/circadian disruption occurred in all the participants with schizophrenia. Half these individuals showed severe circadian misalignment ranging from phase-advance/delay to non-24 h periods in sleep–wake and melatonin cycles, and the other half showed patterns from excessive sleep to highly irregular and fragmented sleep epochs but with normally timed melatonin production.

Conclusions

Severe circadian sleep/wake disruptions exist despite stability in mood, mental state and newer antipsychotic treatment. They cannot be explained by the individuals' level of everyday function.

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Copyright
Royal College of Psychiatrists, This paper accords with the Wellcome Trust Open Access policy and is governed by the licence available at http://www.rcpsych.ac.uk/pdf/Wellcome%20Trust%20licence.pdf
Corresponding author
Russell G. Foster, University of Oxford, Level 6, West Wing, The John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK. Email: russell.foster@eye.ox.ac.uk
Footnotes
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See editorial, pp. 273–274, this issue.

Declaration of interest

None.

Footnotes
References
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  • ISSN: 0007-1250
  • EISSN: 1472-1465
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Sleep and circadian rhythm disruption in schizophrenia

  • Katharina Wulff (a1), Derk-Jan Dijk (a2), Benita Middleton (a2), Russell G. Foster (a1) and Eileen M. Joyce (a3)...
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