Sleep disturbance and psychiatric disorders

Signs of mental ill health that cut across psychiatric diagnostic categories at high rates are typically viewed as non-specific occurrences, downgraded in importance and disregarded. However, problems not associated with particular diagnoses should be expected if there is shared causation across men...

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Published inThe Lancet. Psychiatry Vol. 7; no. 7; p. 628
Main Authors Freeman, Daniel, Sheaves, Bryony, Waite, Felicity, Harvey, Allison G, Harrison, Paul J
Format Journal Article
LanguageEnglish
Published England 01.07.2020
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Abstract Signs of mental ill health that cut across psychiatric diagnostic categories at high rates are typically viewed as non-specific occurrences, downgraded in importance and disregarded. However, problems not associated with particular diagnoses should be expected if there is shared causation across mental health conditions. If dynamic networks of interacting symptoms are the reality of mental health presentations, then particularly disruptive and highly connected problems should be especially common. The non-specific occurrence might be highly consequential. One non-specific occurrence that is often overlooked is patients' chronic difficulty in getting good sleep. In this Review, we consider whether disrupted sleep might be a contributory causal factor in the occurrence of major types of mental health disorders. It is argued that insomnia and other mental health conditions not only share common causes but also show a bidirectional relationship, with typically the strongest pathway being disrupted sleep as a causal factor in the occurrence of other psychiatric problems. Treating insomnia lessens other mental health problems. Intervening on sleep at an early stage might be a preventive strategy for the onset of clinical disorders. Our recommendations are that insomnia is assessed routinely in the occurrence of mental health disorders; that sleep disturbance is treated in services as a problem in its own right, yet also recognised as a pathway to reduce other mental health difficulties; and that access to evidence-based treatment for sleep difficulties is expanded in mental health services.
AbstractList Signs of mental ill health that cut across psychiatric diagnostic categories at high rates are typically viewed as non-specific occurrences, downgraded in importance and disregarded. However, problems not associated with particular diagnoses should be expected if there is shared causation across mental health conditions. If dynamic networks of interacting symptoms are the reality of mental health presentations, then particularly disruptive and highly connected problems should be especially common. The non-specific occurrence might be highly consequential. One non-specific occurrence that is often overlooked is patients' chronic difficulty in getting good sleep. In this Review, we consider whether disrupted sleep might be a contributory causal factor in the occurrence of major types of mental health disorders. It is argued that insomnia and other mental health conditions not only share common causes but also show a bidirectional relationship, with typically the strongest pathway being disrupted sleep as a causal factor in the occurrence of other psychiatric problems. Treating insomnia lessens other mental health problems. Intervening on sleep at an early stage might be a preventive strategy for the onset of clinical disorders. Our recommendations are that insomnia is assessed routinely in the occurrence of mental health disorders; that sleep disturbance is treated in services as a problem in its own right, yet also recognised as a pathway to reduce other mental health difficulties; and that access to evidence-based treatment for sleep difficulties is expanded in mental health services.
Author Sheaves, Bryony
Harvey, Allison G
Waite, Felicity
Harrison, Paul J
Freeman, Daniel
Author_xml – sequence: 1
  givenname: Daniel
  surname: Freeman
  fullname: Freeman, Daniel
  email: daniel.freeman@psych.ox.ac.uk
  organization: Department of Psychiatry, University of Oxford, Oxford, UK; Health National Health Service Foundation Trust, Oxford, UK. Electronic address: daniel.freeman@psych.ox.ac.uk
– sequence: 2
  givenname: Bryony
  surname: Sheaves
  fullname: Sheaves, Bryony
  organization: Department of Psychiatry, University of Oxford, Oxford, UK; Health National Health Service Foundation Trust, Oxford, UK
– sequence: 3
  givenname: Felicity
  surname: Waite
  fullname: Waite, Felicity
  organization: Department of Psychiatry, University of Oxford, Oxford, UK; Health National Health Service Foundation Trust, Oxford, UK
– sequence: 4
  givenname: Allison G
  surname: Harvey
  fullname: Harvey, Allison G
  organization: Department of Psychology, University of California, Berkeley, CA, USA
– sequence: 5
  givenname: Paul J
  surname: Harrison
  fullname: Harrison, Paul J
  organization: Department of Psychiatry, University of Oxford, Oxford, UK; Health National Health Service Foundation Trust, Oxford, UK
BackLink https://www.ncbi.nlm.nih.gov/pubmed/32563308$$D View this record in MEDLINE/PubMed
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References 36638699 - Gen Hosp Psychiatry. 2023 Jan-Feb;80:48-53. doi: 10.1016/j.genhosppsych.2023.01.002.
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Snippet Signs of mental ill health that cut across psychiatric diagnostic categories at high rates are typically viewed as non-specific occurrences, downgraded in...
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SubjectTerms Comorbidity
Humans
Mental Disorders - epidemiology
Randomized Controlled Trials as Topic
Sleep Initiation and Maintenance Disorders - epidemiology
Title Sleep disturbance and psychiatric disorders
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