Association between pharmacological guideline adherence and actigraphy‐measured sleep variables in long‐term hospitalized patients with schizophrenia
Improving sleep quality is a crucial clinical objective in schizophrenia care; however, the association between evidence-based pharmacological treatment and sleep outcomes remains unclear. This study aimed to examine whether guideline adherence, assessed using the individual fitness score (IFS), cor...
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| Published in | PCN reports Vol. 4; no. 3; p. e70154 |
|---|---|
| Main Authors | , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Australia
John Wiley and Sons Inc
01.09.2025
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| Subjects | |
| Online Access | Get full text |
| ISSN | 2769-2558 2769-2558 |
| DOI | 10.1002/pcn5.70154 |
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| Abstract | Improving sleep quality is a crucial clinical objective in schizophrenia care; however, the association between evidence-based pharmacological treatment and sleep outcomes remains unclear. This study aimed to examine whether guideline adherence, assessed using the individual fitness score (IFS), correlated with actigraphy-measured sleep in long-term hospitalized patients.
We included 40 inpatients aged <65 years who were diagnosed with schizophrenia. Guideline adherence was assessed using the IFS and actigraphy was used to measure total sleep time (TST), sleep latency (SL), and sleep efficiency (SE). In 33 patients, these measures were re-evaluated after 6 months.
Cross-sectional analysis showed a positive correlation between IFS and TST (rho = 0.362,
= 0.022), which persisted after adjusting for Brief Psychiatric Rating Scale scores (
= 0.318,
= 0.024). IFS was not associated with SL or SE, and differences in hypnotic use did not significantly affect the sleep parameters. Additionally, longitudinal changes in IFS over 6 months were not significantly associated with changes in TST, SL, or SE (all
> 0.05).
In this cohort of long-term hospitalized patients with schizophrenia, guideline adherence (higher IFS) was associated with increased TST. However, no clear longitudinal effects of IFS on sleep were observed. These findings emphasize the importance of guideline adherence in optimizing sleep, although extended follow-ups and larger sample sizes are required to confirm the long-term impact of guideline-based treatments on sleep in patients with schizophrenia. |
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| AbstractList | Improving sleep quality is a crucial clinical objective in schizophrenia care; however, the association between evidence-based pharmacological treatment and sleep outcomes remains unclear. This study aimed to examine whether guideline adherence, assessed using the individual fitness score (IFS), correlated with actigraphy-measured sleep in long-term hospitalized patients.AimImproving sleep quality is a crucial clinical objective in schizophrenia care; however, the association between evidence-based pharmacological treatment and sleep outcomes remains unclear. This study aimed to examine whether guideline adherence, assessed using the individual fitness score (IFS), correlated with actigraphy-measured sleep in long-term hospitalized patients.We included 40 inpatients aged <65 years who were diagnosed with schizophrenia. Guideline adherence was assessed using the IFS and actigraphy was used to measure total sleep time (TST), sleep latency (SL), and sleep efficiency (SE). In 33 patients, these measures were re-evaluated after 6 months.MethodsWe included 40 inpatients aged <65 years who were diagnosed with schizophrenia. Guideline adherence was assessed using the IFS and actigraphy was used to measure total sleep time (TST), sleep latency (SL), and sleep efficiency (SE). In 33 patients, these measures were re-evaluated after 6 months.Cross-sectional analysis showed a positive correlation between IFS and TST (rho = 0.362, P = 0.022), which persisted after adjusting for Brief Psychiatric Rating Scale scores (β = 0.318, P = 0.024). IFS was not associated with SL or SE, and differences in hypnotic use did not significantly affect the sleep parameters. Additionally, longitudinal changes in IFS over 6 months were not significantly associated with changes in TST, SL, or SE (all P > 0.05).ResultsCross-sectional analysis showed a positive correlation between IFS and TST (rho = 0.362, P = 0.022), which persisted after adjusting for Brief Psychiatric Rating Scale scores (β = 0.318, P = 0.024). IFS was not associated with SL or SE, and differences in hypnotic use did not significantly affect the sleep parameters. Additionally, longitudinal changes in IFS over 6 months were not significantly associated with changes in TST, SL, or SE (all P > 0.05).In this cohort of long-term hospitalized patients with schizophrenia, guideline adherence (higher IFS) was associated with increased TST. However, no clear longitudinal effects of IFS on sleep were observed. These findings emphasize the importance of guideline adherence in optimizing sleep, although extended follow-ups and larger sample sizes are required to confirm the long-term impact of guideline-based treatments on sleep in patients with schizophrenia.ConclusionIn this cohort of long-term hospitalized patients with schizophrenia, guideline adherence (higher IFS) was associated with increased TST. However, no clear longitudinal effects of IFS on sleep were observed. These findings emphasize the importance of guideline adherence in optimizing sleep, although extended follow-ups and larger sample sizes are required to confirm the long-term impact of guideline-based treatments on sleep in patients with schizophrenia. Correlation between individual fitness score (IFS) and total sleep time (TST). A significant positive correlation was observed between TST and IFS (rho = 0.362, P = 0.022). Improving sleep quality is a crucial clinical objective in schizophrenia care; however, the association between evidence-based pharmacological treatment and sleep outcomes remains unclear. This study aimed to examine whether guideline adherence, assessed using the individual fitness score (IFS), correlated with actigraphy-measured sleep in long-term hospitalized patients. We included 40 inpatients aged <65 years who were diagnosed with schizophrenia. Guideline adherence was assessed using the IFS and actigraphy was used to measure total sleep time (TST), sleep latency (SL), and sleep efficiency (SE). In 33 patients, these measures were re-evaluated after 6 months. Cross-sectional analysis showed a positive correlation between IFS and TST (rho = 0.362, = 0.022), which persisted after adjusting for Brief Psychiatric Rating Scale scores ( = 0.318, = 0.024). IFS was not associated with SL or SE, and differences in hypnotic use did not significantly affect the sleep parameters. Additionally, longitudinal changes in IFS over 6 months were not significantly associated with changes in TST, SL, or SE (all > 0.05). In this cohort of long-term hospitalized patients with schizophrenia, guideline adherence (higher IFS) was associated with increased TST. However, no clear longitudinal effects of IFS on sleep were observed. These findings emphasize the importance of guideline adherence in optimizing sleep, although extended follow-ups and larger sample sizes are required to confirm the long-term impact of guideline-based treatments on sleep in patients with schizophrenia. |
| Author | Sahara, Reiko Washizuka, Shinsuke Sasayama, Daimei Kuraishi, Kazuaki Nakamura, Toshinori Suzuki, Kazuhiro Nakajima, Yuka Fukui, Fumiya Saito, Kentaro Koido, Mika Horiuchi, Aya Arai, Yusuke |
| AuthorAffiliation | 2 Department of Psychiatry Shinshu University School of Medicine Matsumoto Japan 3 Department of Community Mental Health Shinshu University School of Medicine Matsumoto Japan 1 Department of Psychiatry Kurita Hospital Nagano Japan |
| AuthorAffiliation_xml | – name: 2 Department of Psychiatry Shinshu University School of Medicine Matsumoto Japan – name: 1 Department of Psychiatry Kurita Hospital Nagano Japan – name: 3 Department of Community Mental Health Shinshu University School of Medicine Matsumoto Japan |
| Author_xml | – sequence: 1 givenname: Kentaro orcidid: 0009-0001-6535-4585 surname: Saito fullname: Saito, Kentaro organization: Department of Psychiatry Kurita Hospital Nagano Japan, Department of Psychiatry Shinshu University School of Medicine Matsumoto Japan – sequence: 2 givenname: Yusuke orcidid: 0000-0002-3155-6971 surname: Arai fullname: Arai, Yusuke organization: Department of Psychiatry Kurita Hospital Nagano Japan, Department of Psychiatry Shinshu University School of Medicine Matsumoto Japan, Department of Community Mental Health Shinshu University School of Medicine Matsumoto Japan – sequence: 3 givenname: Daimei orcidid: 0000-0003-3450-7283 surname: Sasayama fullname: Sasayama, Daimei organization: Department of Psychiatry Shinshu University School of Medicine Matsumoto Japan – sequence: 4 givenname: Toshinori surname: Nakamura fullname: Nakamura, Toshinori organization: Department of Psychiatry Shinshu University School of Medicine Matsumoto Japan – sequence: 5 givenname: Kazuhiro surname: Suzuki fullname: Suzuki, Kazuhiro organization: Department of Psychiatry Shinshu University School of Medicine Matsumoto Japan, Department of Community Mental Health Shinshu University School of Medicine Matsumoto Japan – sequence: 6 givenname: Mika surname: Koido fullname: Koido, Mika organization: Department of Psychiatry Kurita Hospital Nagano Japan – sequence: 7 givenname: Reiko surname: Sahara fullname: Sahara, Reiko organization: Department of Psychiatry Kurita Hospital Nagano Japan – sequence: 8 givenname: Yuka surname: Nakajima fullname: Nakajima, Yuka organization: Department of Psychiatry Kurita Hospital Nagano Japan – sequence: 9 givenname: Aya surname: Horiuchi fullname: Horiuchi, Aya organization: Department of Psychiatry Kurita Hospital Nagano Japan – sequence: 10 givenname: Fumiya surname: Fukui fullname: Fukui, Fumiya organization: Department of Psychiatry Kurita Hospital Nagano Japan – sequence: 11 givenname: Kazuaki surname: Kuraishi fullname: Kuraishi, Kazuaki organization: Department of Psychiatry Kurita Hospital Nagano Japan – sequence: 12 givenname: Shinsuke surname: Washizuka fullname: Washizuka, Shinsuke organization: Department of Psychiatry Shinshu University School of Medicine Matsumoto Japan |
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| Cites_doi | 10.1016/S1087-0792(02)00158-2 10.1093/oxfordjournals.schbul.a007145 10.1111/pcn.13578 10.1111/j.1742-1241.2012.02987.x 10.1038/s41537-023-00407-3 10.1111/pcn.12275 10.1192/bjo.2022.44 10.1093/ijnp/pyad037 10.1093/schbul/sbaa024 10.1093/ijnp/pyac036 10.1016/j.comppsych.2019.02.006 10.1176/appi.ajp.2020.20070968 10.1016/j.schres.2014.10.002 10.1016/j.smrv.2016.05.002 10.3390/jcm10071513 10.1016/j.smrv.2020.101332 10.1016/j.schres.2015.11.014 10.1111/j.0924-2708.2004.00103.x 10.1002/npr2.12193 10.1002/npr2.12293 10.1016/j.sleep.2021.11.005 10.1176/appi.ajp.2015.15050618 10.1111/pcn.12911 10.2165/00023210-200822110-00004 10.1037/bul0000053 10.1001/jamapsychiatry.2019.3360 10.1176/appi.books.9780890425596 10.1016/j.smrv.2008.06.001 |
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| Keywords | sleep hypnotic schizophrenia pharmacotherapy guideline |
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| Title | Association between pharmacological guideline adherence and actigraphy‐measured sleep variables in long‐term hospitalized patients with schizophrenia |
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