Sleep and circadian rhythm disruption in schizophrenia
2011/12/23 by Katharina Wulff, Derk‐Jan Dijk, Derk-Jan Dijk +4 · 436 citations
Medicine · Neuroscience · Psychology · #Actigraphy #Antipsychotic #Circadian clock #Circadian rhythm #Circadian rhythm and melatonin #Dark therapy #Delayed sleep phase #Free-running sleep #Insomnia #Internal medicine #Light effects on circadian rhythm #Medicine #Melatonin #Mood #Neuroscience #Psychiatry #Psychology #Schizophrenia (object-oriented programming) #Sleep (system call) #Sleep and Wakefulness Research #Sleep and related disorders #Sleep disorder
paper · pdf · doi:10.1192/bjp.bp.111.096321
published in The British Journal of Psychiatry 200(4), 308-316 (Cambridge University Press)
openalex publication_date 2011/12/23 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/03
Abstract
BACKGROUND: Sleep disturbances comparable with insomnia occur in up to 80% of people with schizophrenia, but very little is known about the contribution of circadian coordination to these prevalent disruptions. AIMS: A systematic exploration of circadian time patterns in individuals with schizophrenia with recurrent sleep disruption. METHOD: We examined the relationship between sleep-wake activity, recorded actigraphically over 6 weeks, along with ambient light exposure and simultaneous circadian clock timing, by collecting weekly 48 h profiles of a urinary metabolite of melatonin in 20 out-patients with schizophrenia and 21 healthy control individuals matched for age, gender and being unemployed. RESULTS: Significant sleep/circadian disruption occurred in all the participants with schizophrenia. Half these individuals showed severe circadian misalignment ranging from phase-advance/delay to non-24 h periods in sleep-wake and melatonin cycles, and the other half showed patterns from excessive sleep to highly irregular and fragmented sleep epochs but with normally timed melatonin production. CONCLUSIONS: Severe circadian sleep/wake disruptions exist despite stability in mood, mental state and newer antipsychotic treatment. They cannot be explained by the individuals' level of everyday function.
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