Sleep state misperception in schizophrenia: Are negative symptoms at work?
OBJECTIVE
This study investigates subjective and objective sleep quality to ascertain whether there is a sleep state misperception in schizophrenia patients, as well as analyze potential effect factors.


METHODS
A total of 148 inpatients with schizophrenia admitted to Beijing HuiLongGuan Hospital were enrolled in this study. The quality of objective sleep was assessed by polysomnography (PSG). On the second day after the successful completion of the PSG evaluation, an interview was arranged to collect patients' recorded subjective evaluation on sleep time, sleep latency, and wake times. Demographic information was collected from an interview, medical records were reviewed, and psychiatric symptoms were assessed using the Positive And Negative Symptom Scale (PANSS).


RESULTS
The main finding of this study was that schizophrenic patients exhibited sleep state misperception with a pattern of overestimation of total sleep time (TST) as well as sleep efficiency (SE), and an underestimation of sleep onset latency (SOL). Regarding the ±standard deviation of the differences between subjective and objective TST as a clinical acceptable range, the patients were divided into three groups: the overestimate group, the normal group, and the underestimate group. The differences of total PANSS score, especially the PANSS-N score in the overestimate group, the normal group and the underestimate group were significant, and there were significant differences between the overestimate group and the other groups.


CONCLUSIONS
A comprehensive evaluation of the subjective and objective sleep quality in patients with schizophrenia is needed, especially when negative symptoms are severe.
Department of Psychosomatic Medicine, Beijing HuiLongGuan Hospital, Peking University, Beijing 100096, PR China.
Yun
Y
Bian
Department of Psychology, Beijing HuiLongGuan Hospital, Peking University, Beijing 100096, PR China. Electronic address: azxsdcvf123@126.com.
Zhi Xiong
ZX
Wang
Department of Psychosomatic Medicine, Beijing HuiLongGuan Hospital, Peking University, Beijing 100096, PR China.
Xiao Le
XL
Han
Department of Psychosomatic Medicine, Beijing HuiLongGuan Hospital, Peking University, Beijing 100096, PR China.
Li
L
Chen
Department of Psychosomatic Medicine, Beijing HuiLongGuan Hospital, Peking University, Beijing 100096, PR China.
Yu
Y
Zhu
Center for sleep Medicine, Beijing HuiLongGuan Hospital, Peking University, Beijing 100096, PR China.
Cheng Jing
CJ
Wu
D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy; D012565:Schizophrenic Psychology; D012890:Sleep / Q000502:physiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000503:physiopathology* / Q000523:psychology; D055815:Young Adult
D014150:Antipsychotic Agents