Digital sleep phenotype and wrist actigraphy in individuals at clinical high risk for psychosis and people with schizophrenia spectrum disorders: a systematic review and meta-analysis
Aim To identify sleep abnormalities in individuals at clinical high risk for psychosis (CHR-P) or with schizophrenia spectrum disorders (SSDs) compared with healthy controls (HCs) using wrist actigraphy, and to assess potential differences in the direction of effect with self-reported assessments of...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2025-02-01
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| Series: | BMJ Mental Health |
| Online Access: | https://mentalhealth.bmj.com/content/28/1/e301337.full |
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| author | Andrea Cipriani Edoardo Giuseppe Ostinelli John Torous Paolo Brambilla Philip McGuire Dominic Oliver Rosario Aronica Charlotte Austin |
| author_facet | Andrea Cipriani Edoardo Giuseppe Ostinelli John Torous Paolo Brambilla Philip McGuire Dominic Oliver Rosario Aronica Charlotte Austin |
| author_sort | Andrea Cipriani |
| collection | DOAJ |
| description | Aim To identify sleep abnormalities in individuals at clinical high risk for psychosis (CHR-P) or with schizophrenia spectrum disorders (SSDs) compared with healthy controls (HCs) using wrist actigraphy, and to assess potential differences in the direction of effect with self-reported assessments of sleep.Methods We conducted a systematic review of observational studies, with the search last updated on 29 April 2024. Primary outcome was total sleep time (TST), with secondary outcomes including time in bed (TIB), sleep latency, sleep efficiency, wake after sleep onset, nighttime awakenings and self-reported sleep quality. Random-effects pairwise meta-analyses were used to summarise the effects of each outcome.Results Nineteen studies were included, with 18 contributing to the meta-analyses (202 CHR-P, 584 SSD, 582 HC). TST results were inconclusive for CHR-P (MD −4.88 min (95% CI −20.57 to 10.81)), while SSD participants showed an increase in TST compared with HC (MD 106.13 min (86.02 to 124.24)). Factors such as antipsychotic medications (pseudo-R²=88.14%), age (38.89%) and gender (26.29%) partially explained the heterogeneity between subgroups. Additionally, CHR-P individuals exhibited reduced sleep efficiency (MD −2.04% (−3.55 to 0.53)), whereas SSD participants had increased TIB (MD 121.58 min (88.16 to 155.00)) and sleep latency (MD 13.05 min (2.11 to 24.00)). The risk-of-bias assessment ranged from some concerns to high risk.Conclusions Our analyses identified sleep abnormalities in CHR-P and SSD compared with placebo. However, observed heterogeneity and potential biases across studies may limit the interpretability of findings. These limitations underscore the need for standardised guidelines and more precise participant stratification. |
| format | Article |
| id | doaj-art-29a91421177b4dd6bbf5d0c71a1b1fda |
| institution | Kabale University |
| issn | 2755-9734 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Mental Health |
| spelling | doaj-art-29a91421177b4dd6bbf5d0c71a1b1fda2025-02-11T08:50:09ZengBMJ Publishing GroupBMJ Mental Health2755-97342025-02-0128110.1136/bmjment-2024-301337Digital sleep phenotype and wrist actigraphy in individuals at clinical high risk for psychosis and people with schizophrenia spectrum disorders: a systematic review and meta-analysisAndrea Cipriani0Edoardo Giuseppe Ostinelli1John Torous2Paolo Brambilla3Philip McGuire4Dominic Oliver5Rosario Aronica6Charlotte Austin7Warneford Hospital, Oxford Health NHS Foundation Trust, Oxford, England, UKDepartment of Psychiatry, University of Oxford, Oxford Precision Psychiatry Lab (OxPPL), Oxford, UKPsychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USADepartment of Pathophysiology and Transplantation, University of Milan, Milano, ItalyDepartment of Psychiatry, University of Oxford, Oxford, England, UKDepartment of Psychiatry, University of Oxford, Oxford, England, UKDepartment of Pathophysiology and Transplantation, University of Milan, Milano, ItalyDepartment of Psychiatry, University of Oxford, Oxford, England, UKAim To identify sleep abnormalities in individuals at clinical high risk for psychosis (CHR-P) or with schizophrenia spectrum disorders (SSDs) compared with healthy controls (HCs) using wrist actigraphy, and to assess potential differences in the direction of effect with self-reported assessments of sleep.Methods We conducted a systematic review of observational studies, with the search last updated on 29 April 2024. Primary outcome was total sleep time (TST), with secondary outcomes including time in bed (TIB), sleep latency, sleep efficiency, wake after sleep onset, nighttime awakenings and self-reported sleep quality. Random-effects pairwise meta-analyses were used to summarise the effects of each outcome.Results Nineteen studies were included, with 18 contributing to the meta-analyses (202 CHR-P, 584 SSD, 582 HC). TST results were inconclusive for CHR-P (MD −4.88 min (95% CI −20.57 to 10.81)), while SSD participants showed an increase in TST compared with HC (MD 106.13 min (86.02 to 124.24)). Factors such as antipsychotic medications (pseudo-R²=88.14%), age (38.89%) and gender (26.29%) partially explained the heterogeneity between subgroups. Additionally, CHR-P individuals exhibited reduced sleep efficiency (MD −2.04% (−3.55 to 0.53)), whereas SSD participants had increased TIB (MD 121.58 min (88.16 to 155.00)) and sleep latency (MD 13.05 min (2.11 to 24.00)). The risk-of-bias assessment ranged from some concerns to high risk.Conclusions Our analyses identified sleep abnormalities in CHR-P and SSD compared with placebo. However, observed heterogeneity and potential biases across studies may limit the interpretability of findings. These limitations underscore the need for standardised guidelines and more precise participant stratification.https://mentalhealth.bmj.com/content/28/1/e301337.full |
| spellingShingle | Andrea Cipriani Edoardo Giuseppe Ostinelli John Torous Paolo Brambilla Philip McGuire Dominic Oliver Rosario Aronica Charlotte Austin Digital sleep phenotype and wrist actigraphy in individuals at clinical high risk for psychosis and people with schizophrenia spectrum disorders: a systematic review and meta-analysis BMJ Mental Health |
| title | Digital sleep phenotype and wrist actigraphy in individuals at clinical high risk for psychosis and people with schizophrenia spectrum disorders: a systematic review and meta-analysis |
| title_full | Digital sleep phenotype and wrist actigraphy in individuals at clinical high risk for psychosis and people with schizophrenia spectrum disorders: a systematic review and meta-analysis |
| title_fullStr | Digital sleep phenotype and wrist actigraphy in individuals at clinical high risk for psychosis and people with schizophrenia spectrum disorders: a systematic review and meta-analysis |
| title_full_unstemmed | Digital sleep phenotype and wrist actigraphy in individuals at clinical high risk for psychosis and people with schizophrenia spectrum disorders: a systematic review and meta-analysis |
| title_short | Digital sleep phenotype and wrist actigraphy in individuals at clinical high risk for psychosis and people with schizophrenia spectrum disorders: a systematic review and meta-analysis |
| title_sort | digital sleep phenotype and wrist actigraphy in individuals at clinical high risk for psychosis and people with schizophrenia spectrum disorders a systematic review and meta analysis |
| url | https://mentalhealth.bmj.com/content/28/1/e301337.full |
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