Sleep profiles and CBT-I response in schizophrenia and related psychoses

Vivian W. Chiu, Melissa Ree, Aleksandar Janca, Rajan Iyyalol, Milan Dragovic, Flavie Waters

Research output: Contribution to journalArticle

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Abstract

This study investigated sleep subtypes in schizophrenia, and their response to Cognitive Behavioural Therapy for Insomnia (CBT-I) treatment. Sleep profiling was conducted using latent class analysis on baseline Pittsburgh Sleep Quality Index data (N = 74 outpatients with schizophrenia who were poor sleepers, 52% male, mean age = 41.4 years). Of these, 40 took part in CBT-I treatment. Analyses revealed three sleep subtypes based on total sleep time (TST), sleep efficiency (SE), and sleep onset latency (SOL) parameters: Cluster 1 (‘classic severe insomnia’ 44.6%), Cluster 2 (‘insomnia with normal sleep duration’ 37.8%), and Cluster 3 (‘insomnia with hypersomnia’ 17.6%). Gains analysis of pre- and post-treatment data from CBT-I participants revealed improvements in sleep and psychopathology in all three clusters, although there were some group differences in the areas and magnitude of improvement. Cluster 1 showed the greatest benefits with longer TST and improved SE. Cluster 2 showed a comparatively blunted treatment response although TST moved closer to recommended sleep guidelines. Cluster 3 showed significant reductions in TST. Altogether, this is the first demonstration of different sleep profiles in schizophrenia and their influence on treatment response to CBT-I. It also supports the notion that therapies should be tailored to the person and their insomnia presentation.

Original languageEnglish
Pages (from-to)279-287
Number of pages9
JournalPsychiatry Research
Volume268
DOIs
Publication statusPublished - 1 Oct 2018

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Sleep Initiation and Maintenance Disorders
Cognitive Therapy
Psychotic Disorders
Schizophrenia
Sleep
Therapeutics
Disorders of Excessive Somnolence
Psychopathology

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title = "Sleep profiles and CBT-I response in schizophrenia and related psychoses",
abstract = "This study investigated sleep subtypes in schizophrenia, and their response to Cognitive Behavioural Therapy for Insomnia (CBT-I) treatment. Sleep profiling was conducted using latent class analysis on baseline Pittsburgh Sleep Quality Index data (N = 74 outpatients with schizophrenia who were poor sleepers, 52{\%} male, mean age = 41.4 years). Of these, 40 took part in CBT-I treatment. Analyses revealed three sleep subtypes based on total sleep time (TST), sleep efficiency (SE), and sleep onset latency (SOL) parameters: Cluster 1 (‘classic severe insomnia’ 44.6{\%}), Cluster 2 (‘insomnia with normal sleep duration’ 37.8{\%}), and Cluster 3 (‘insomnia with hypersomnia’ 17.6{\%}). Gains analysis of pre- and post-treatment data from CBT-I participants revealed improvements in sleep and psychopathology in all three clusters, although there were some group differences in the areas and magnitude of improvement. Cluster 1 showed the greatest benefits with longer TST and improved SE. Cluster 2 showed a comparatively blunted treatment response although TST moved closer to recommended sleep guidelines. Cluster 3 showed significant reductions in TST. Altogether, this is the first demonstration of different sleep profiles in schizophrenia and their influence on treatment response to CBT-I. It also supports the notion that therapies should be tailored to the person and their insomnia presentation.",
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Sleep profiles and CBT-I response in schizophrenia and related psychoses. / Chiu, Vivian W.; Ree, Melissa; Janca, Aleksandar; Iyyalol, Rajan; Dragovic, Milan; Waters, Flavie.

In: Psychiatry Research, Vol. 268, 01.10.2018, p. 279-287.

Research output: Contribution to journalArticle

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