Abstract

BackgroundThere is a lack of studies exploring associations between sleep and quality of life (QOL) among patients with schizophrenia who have limited exposure to antipsychotics and are in the early stage of their illness. Our study investigates the association of poor sleep quality and its components with domains of QOL amongst patients with first episode psychosis (FEP).MethodsData was utilized from a longitudinal study that examined sleep, smoking and alcohol use amongst patients with FEP who were enrolled in the Early Psychosis Intervention Programme (EPIP). The data were collected during the patients’ baseline visit; i.e., within 3 months of admission into the EPIP. The Pittsburgh Sleep Quality Index (PSQI) was employed to examine sleep quality and its 7 components over the last month. The WHO quality of life-BREF was used to examine QOL and its 4 domains: physical health, psychological, social relationship, and environment. Clinical data such as Positive and Negative Syndrome Scale (PANSS) and Global Assessment of Functioning (GAF) scores were obtained from a clinical data base. Linear regression analyses were conducted to investigate the association between poor sleep quality and the domains of QOL.ResultsAmongst the 280 recruited patients, 62.9% suffered from poor sleep quality. Poor sleep quality was associated with significantly lower scores in all domains of QOL, despite controlling for socio-demographics and clinical variables. Respondents with higher scores in subjective sleep quality and daytime dysfunction were associated with lower scores in the physical health and social relationship domain. Furthermore, respondents with higher scores in subjective sleep quality, sleep latency and daytime dysfunction were associated with lower scores in the psychological domain of QOL. Finally, respondents with higher scores in subjective sleep quality were associated with lower scores in the environment domain of QOL.ConclusionsOur findings highlight the importance of monitoring sleep quality amongst patients with FEP to improve their QOL. Clinical programmes should also pay more attention to sleep components in order to maintain satisfactory QOL amongst patients with FEP. Future interventions should focus on improving the relevant sleep components to ensure better treatment outcomes.

Highlights

  • Schizophrenia is a disabling psychiatric illness that is characterized by symptoms such as hallucinations and delusions, and disruption of thinking for an extensive period of time [1]

  • Parental consent was sought for participants who were less than 21 years of age as they are considered minors according to Singapore laws

  • Respondents with higher scores in subjective sleep quality and daytime dysfunction were associated with lower scores in the physical health (Table 3) and social relationship domains of quality of life (QOL) (Table 4)

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Summary

Introduction

Schizophrenia is a disabling psychiatric illness that is characterized by symptoms such as hallucinations and delusions, and disruption of thinking for an extensive period of time [1]. The World Health Organization ranked schizophrenia as one of the top 20 leading causes of disability, among other conditions such as loss of hearing, depression and macular degeneration [2]. It is well-established that patients with schizophrenia are likely to suffered from poorer quality of life (QOL) [3, 4]. There is a lack of studies exploring associations between sleep and quality of life (QOL) among patients with schizophrenia who have limited exposure to antipsychotics and are in the early stage of their illness. Our study investigates the association of poor sleep quality and its components with domains of QOL amongst patients with first episode psychosis (FEP)

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