Aug 2026· Progress in Neuro-psychopharmacology and Biological Psychiatry· Vol 149, pp.
111907
· 0 citations· 50 references
Medicine
TL;DR
Poor sleep quality is associated with symptom severity in schizophrenia, including later illness onset, independent of chronotype or BDNF Val66Met variant.
Abstract
Sleep disturbances are prevalent in schizophrenia and are associated with symptom severity, yet findings remain inconsistent, reflecting unmeasured biological moderators. Chronotype and the BDNF genetic variant influence sleep regulation and schizophrenia-related phenotypes. However, their combined contribution to the sleep quality-symptom severity association remains unexplored. We aimed to characterise sleep quality and chronotype in schizophrenia, examine their associations with symptom severity, and determine whether BDNF Val66Met moderates these relationships. In this cross-sectional study, 217 individuals with schizophrenia were assessed for sleep quality (Pittsburgh Sleep Quality Index), chronotype (Morningness-Eveningness Questionnaire), and symptom severity (Positive and Negative Syndrome Scale) and genotyped for BDNF Val66Met. Multivariate regression evaluated the contributions of sleep quality, chronotype, and Val66Met genotype to symptom severity scores, adjusting for covariates. Plasma BDNF levels were measured in a subset of patients (n = 91). Poor sleep quality was prevalent in schizophrenia (69.12%) and was significantly associated with PANSS total (β = 0.35, P < 0.001), positive (β = 0.24, P < 0.001), negative (β = 0.27, P < 0.001), and general psychopathology scores (β = 0.31, P < 0.001). Schizophrenia patients with poor sleep quality had later illness onset (P = 0.02). Morning chronotype was associated with longer illness duration (P = 0.03) but lower general psychopathology (P = 0.02). BDNF Val66Met showed no association with sleep, chronotype, or symptom severity and did not moderate sleep-symptom relationships. Plasma BDNF levels were higher in poor sleepers (P < 0.001, r = 0.65), independent of Val66Met genotype. Our results showed poor sleep quality is associated with symptom severity in schizophrenia, including later illness onset, independent of chronotype or BDNF Val66Met variant.
Background: Metabolic syndrome (MS) significantly contributes to premature mortality in schizophrenia, which is driven by multiple biological and behavioral factors. While individual risk factors are known, comprehensive studies examining the combined influence of biological markers (adiponectin) and behavioral factors (sleep, lifestyle) in the Indian context are limited. Methods: In this cross-sectional, observational study, 130 patients diagnosed with schizophrenia were assessed for MS using modified National Cholesterol Education Program Adult Treatment Panel III criteria. We evaluated symptom severity using the Brief Psychiatric Rating Scale, Sleep quality using the Pittsburgh Sleep Quality Index, and lifestyle behaviors using the Health-Promoting Lifestyle Profile-II. Blood samples were analyzed for serum adiponectin and metabolic profiles to diagnose MS. Results: The MS rate was 24.6%. Bivariate analyses revealed that patients with MS had a significantly longer time spent in exacerbation (p = .03), a longer treatment duration (p = .01), lower serum adiponectin levels (p = .02), poorer sleep quality (p = .001), and lower physical activity and nutritional habit scores (p = .01). In the multivariable logistic regression model, poorer sleep quality (OR = 1.17, 95% CI = 1.06–1.30, p = .002) and a lower physical activity and nutritional habit score (OR = 0.92, 95% CI = 0.86–0.98, p = .01) emerged as significant predictors of MS. Conclusions: One-fourth of the patients with schizophrenia had MS in this cohort. Notably, modifiable behavioral factors—specifically sleep quality and lifestyle—were stronger predictors of metabolic risk. This signifies the vital need to integrate routine screening for cardiometabolic risk factors and to apply therapeutic strategies into the standard of care for schizophrenia.
Smit Ratilal Makwana, N. Nebhinani, Pranshu Singh et al.· Indian Journal of Psychologi...· 0 citations
ABSTRACT Evening chronotype is overrepresented in adults with attention-deficit/hyperactivity disorder (ADHD), yet how circadian preference relates to specific symptom dimensions remains unclear. Cognitive Disengagement Syndrome (CDS; formerly Sluggish Cognitive Tempo), characterized by daydreaming, mental fogginess, and hypoarousal, is considered distinct from ADHD despite overlap and may be relevant to associations among chronotype, sleep, and attentional symptoms. This cross-sectional study tested an a priori serial mediation model in 100 treatment-seeking adults with attentional complaints and no prior ADHD diagnosis or pharmacotherapy. Participants completed the Morningness–Eveningness Questionnaire, Pittsburgh Sleep Quality Index, Barkley Adult Sluggish Cognitive Tempo Rating Scale, and Adult ADHD Self-Report Scale (ASRS-v1.1). Eveningness was associated with poorer sleep quality, and poorer sleep quality with higher CDS symptoms. CDS was strongly associated with both inattention and hyperactivity/impulsivity. The serial indirect effects through sleep quality and CDS were significant for both dimensions, whereas simple indirect effects were not. The full models explained 50.0% and 21.3% of the variance in inattention and hyperactivity/impulsivity, respectively. Supplementary analyses localized this effect to the Daydreaming rather than Sluggishness subdimension. Findings were robust to age- and sex-adjustment. These findings suggest sleep quality and CDS are clinically relevant correlates of ADHD symptom dimensions, though longitudinal confirmation is needed.
Opioid Use Disorder (OUD) carries a high risk of psychiatric comorbidities, such as depression, sleep disturbances and suicidal behaviour. Recent findings emphasise the impact of chronotype and biological rhythm disturbances on the severity of addiction and suicidality. This study examined the associations between chronotype, biological rhythm characteristics, sleep quality, depressive symptoms and suicidal behaviour in individuals with OUD. A total of 159 patients diagnosed with OUD and 154 healthy controls were evaluated using validated scales, including the Columbia Suicide Severity Rating Scale, Biological Rhythm Assessment Interview, Morningness-Eveningness Questionnaire, Pittsburgh Sleep Quality Index, Beck Depression Inventory and Addiction Profile Index. The results showed that individuals with OUD had significantly higher rates of suicidal ideation and attempts, poorer sleep quality, more irregular biological rhythms and more severe depressive symptoms than the control group. An evening chronotype was more prevalent in the OUD group and was associated with greater addiction severity, disrupted rhythms, poor sleep quality, and increased suicidality. Higher depression severity was significantly associated with lower morningness preferences, and sleep quality was found to explain a significant portion of the shared variance between depressive symptoms and suicidal outcomes. These findings suggest that assessing chronotype and circadian dysregulation could help to identify high-risk patients and inform the development of targeted interventions to improve outcomes in OUD treatment.
Meryem Topal, M. Ergelen· Chronobiology International· 0 citations
Findings indicate that genetically determined short sleep duration and insomnia symptoms are associated with mental and neurological problems, cardiovascular disease and musculoskeletal disorders, suggesting a potentially preventive, causal role of healthy sleeping patterns on chronic disease.
Marta H Hernandez, Camille Lassale, A. Camps-Vilaró et al.· Journal of Sleep Research· 0 citations
ABSTRACT According to the functional ensemble of temperament (FET) model, individual differences in temperament arise from the balance of neurotransmitter systems also crucial for regulating circadian rhythms and sleep, suggesting a strong neurobiological link between temperament and sleep behavior. The present cross‐sectional study examined whether FET‐defined temperamental traits predict interindividual variation in sleep measures. A total of 394 healthy adults completed the Structure of Temperament Questionnaire (STQ‐77) and validated measures of sleep quality, insomnia severity, daytime sleepiness, and presleep arousal, together with indices of anxiety and depression. Several temperamental traits showed robust associations with sleep outcomes. Neuroticism and impulsivity were associated with poorer sleep quality, greater insomnia severity, and heightened presleep cognitive arousal; these effects were largely mediated by anxiety and depression. Higher social tempo was associated with better sleep and reduced daytime sleepiness. Additional associations emerged for empathy, probabilistic thinking, plasticity, and physical endurance, indicating that orientation, integration, and maintenance FET systems contribute to shaping sleep behavior. These findings indicate that stable, neurochemically grounded temperamental traits may shape interindividual sleep differences, with affective distress as a central mediator. Integrating temperament models into sleep research provides a biologically coherent framework for identifying both risk and resilience factors and informs personalized sleep interventions.
S. Lasaponara, A. Scuderi, Elisa Pellegrini et al.· Personality and Mental Healt...· 0 citations
While sleep fragmentation was associated with depressive symptoms, insomnia symptoms appear to be a key factor in assessing insomnia in depression and vice versa and addressing these conditions, may be useful for reducing symptom burden.
J. Theorell-Haglöw, G. Wittert, Robert Adams et al.· Journal of Sleep Research· 0 citations
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