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Do sleep disturbances contribute to cognitive impairments in schizophrenia spectrum and bipolar disorders?

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Abstract

Sleep disturbances and cognitive impairments are both frequent across psychotic disorders, with debilitating effects on functioning and quality of life. This study aims to investigate if sleep disturbances are related to cognitive impairments in schizophrenia spectrum (SCZ) and bipolar disorders (BD), if this relationship varies between different sleep disturbances (insomnia, hypersomnia or delayed sleep phase (DSP)) and lastly, if this relationship differs between clinical groups and healthy controls (HC). We included 797 patients (SCZ = 457, BD = 340) from the Norwegian Centre for Mental Disorders Research (NORMENT) study in Norway. Sleep disturbances were based on items from the Inventory of Depressive Symptoms—Clinician rated scale (IDS-C). Their relationship with several cognitive domains was tested using separate ANCOVAs. A three-way between-groups ANOVA was conducted to test if the relationship with cognitive impairments varies between different sleep disturbances. These analyses revealed significantly poorer processing speed and inhibition in those with any sleep disturbance versus those without, also after adjusting for several covariates. The relationship between sleep disturbances and cognition was similar across SCZ and BD, and there were significant effects of insomnia and hypersomnia on both processing speed and inhibition. No association between sleep disturbances and cognition was found in HC. Sleep disturbances contribute to cognitive impairments in psychotic disorders. Processing speed and inhibition is poorer in patients with sleep disturbances. Impairments in these domains are related to insomnia and hypersomnia. These findings suggest that treating sleep disturbances is important to protect cognitive functioning, alongside cognitive remediation in psychotic disorders.

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Abbreviations

DSP:

Delayed sleep phase

SCZ:

Schizophrenia

BD:

Bipolar disorder

HC:

Healthy controls

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Acknowledgements

We thank the patients who took part in the study as well as the Norwegian Centre for Mental Disorders Research (NORMENT), which contributed to the data collection.

Funding

This study was funded by grants from the University of Oslo, South-Eastern Norway Health Authority (#2012-132, 2014-102), and the Research Council of Norway (#223273).

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Authors and Affiliations

  1. NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Bygg 49, Ullevål sykehus, Nydalen, PO Box 4956, 0424, Oslo, Norway

    Jannicke Fjæra Laskemoen, Camilla Büchmann, Margrethe Collier-Høegh, Beathe Haatveit, Trude Jahr Vedal, Torill Ueland, Ingrid Melle, Monica Aas & Carmen Simonsen

  2. Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital Trust, Oslo, Norway

    Elizabeth Ann Barrett & Carmen Simonsen

  3. Department of Psychology, University of Oslo, Oslo, Norway

    Torill Ueland

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  1. Jannicke Fjæra Laskemoen
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Correspondence to Jannicke Fjæra Laskemoen.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of The Regional Research Committee #2009/2485 and with the 1964 Helsinki declaration and its later amendment.

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Laskemoen, J.F., Büchmann, C., Barrett, E.A. et al. Do sleep disturbances contribute to cognitive impairments in schizophrenia spectrum and bipolar disorders?. Eur Arch Psychiatry Clin Neurosci 270, 749–759 (2020). https://doi.org/10.1007/s00406-019-01075-0

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