Open AccessSleep and mental disorders: A meta-analysis of polysomnographic research.
Author(s) -
Chiara Baglioni,
Svetoslava Nanovska,
Wolfram Regen,
Kai Spiegelhalder,
Bernd Feige,
Christoph Nissen,
Charles F. Reynolds,
Dieter Riemann
Publication year - 2016
Publication title -
psychological bulletin
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 10.737
H-Index - 313
eISSN - 1939-1455
pISSN - 0033-2909
DOI - 10.1037/bul0000053
Subject(s) - comorbidity , psychology , anxiety , schizophrenia (object oriented programming) , clinical psychology , non rapid eye movement sleep , psychiatry , meta analysis , sleep (system call) , generalized anxiety disorder , arousal , attention deficit hyperactivity disorder , medicine , electroencephalography , neuroscience , computer science , operating system
Investigating sleep in mental disorders has the potential to reveal both disorder-specific and transdiagnostic psychophysiological mechanisms. This meta-analysis aimed at determining the polysomnographic (PSG) characteristics of several mental disorders. Relevant studies were searched through standard strategies. Controlled PSG studies evaluating sleep in affective, anxiety, eating, pervasive developmental, borderline and antisocial personality disorders, attention-deficit-hyperactivity disorder (ADHD), and schizophrenia were included. PSG variables of sleep continuity, depth, and architecture, as well as rapid-eye movement (REM) sleep were considered. Calculations were performed with the "Comprehensive Meta-Analysis" and "R" software. Using random effects modeling, for each disorder and each variable, a separate meta-analysis was conducted if at least 3 studies were available for calculation of effect sizes as standardized means (Hedges' g). Sources of variability, that is, sex, age, and mental disorders comorbidity, were evaluated in subgroup analyses. Sleep alterations were evidenced in all disorders, with the exception of ADHD and seasonal affective disorders. Sleep continuity problems were observed in most mental disorders. Sleep depth and REM pressure alterations were associated with affective, anxiety, autism and schizophrenia disorders. Comorbidity was associated with enhanced REM sleep pressure and more inhibition of sleep depth. No sleep parameter was exclusively altered in 1 condition; however, no 2 conditions shared the same PSG profile. Sleep continuity disturbances imply a transdiagnostic imbalance in the arousal system likely representing a basic dimension of mental health. Sleep depth and REM variables might play a key role in psychiatric comorbidity processes. Constellations of sleep alterations may define distinct disorders better than alterations in 1 single variable. (PsycINFO Database Record