The Vitality of Sleep as a Clinical Target for Psychosis Patients

Psychosis patients often experience comorbid sleep disorders, but there is still much to learn about how sleep issues impact psychotic disorders and what clinicians can do to help.

Neurology Learning Network spoke with Ahmad Mayeli, PhD, department of psychiatry, University of Pittsburg, about his study “Sleep Abnormalities in Different Clinical Stages of Psychosis,” recently published in JAMA Psychiatry.

In Part 2 of this Q&A, Dr Mayeli explains the practical implications of his study for clinicians, the next steps in research on this topic, and emphasizes the importance of paying attention to sleep quality in psychosis patients.

Missed Part 1 of this Q&A? Find it here. For more expert insights, visit our Sleep Disorders Excellence Forum.

Evi Arthur, Associate Digital Editor, Neurology Learning Network (NLN): What practical applications of your findings exist for clinicians treating sleep disorders in patients experience psychosis?  

Ahmad Mayeli, PhD: While our study focused primarily on patients with schizophrenia, previous research has demonstrated that sleep disturbances are also prevalent in individuals with other psychiatric disorders. It is important for future research to examine the specific nature and impact of sleep disturbances in these disorders, and to develop tailored interventions that address the unique needs of these patients.

Arthur, NLN: Are you conducting any more research in this area, and what other studies do you feel are needed?  

Dr Mayeli: To further advance our understanding of the relationship between sleep and psychosis, there are several key areas of research that we are trying to pursue.  We aim to expand our knowledge to other psychiatric disorders. Additionally, we are conducting longitudinal studies to track at-risk populations, with the aim of characterizing the interplay between sleep abnormalities and psychosis. We believe that these avenues of research will contribute significantly to our understanding of the role that sleep disturbances play in psychiatric disorders and ultimately help to inform more effective interventions and treatments for patients.

Additional studies are also needed to understand the role of antipsychotic medications and their impact on sleep throughout different stages of psychosis. By exploring how these medications affect sleep by both physicians and researchers, we may be able to optimize treatments and improve outcomes for individuals with psychosis. Furthermore, we believe that it is important to explore spindle properties from prodromal to chronic stages of psychosis to determine whether they may serve as risk, monitoring, and/or prognostic biomarkers for the disorder.

Arthur, NLN: Any final thoughts or takeaways for clinicians pertaining to this research? 

Dr Mayeli: Our systematic review and meta-analysis has shown that sleep disturbances are a common occurrence in individuals across stages of psychosis, highlighting the importance of recognizing sleep as a vital clinical target and research area for these individuals. Since sleep problems have a significant impact on the severity of psychotic symptoms and overall prognosis, it is imperative that physicians prioritize the assessment of sleep in the regular evaluations of these individuals. Additionally, interventions that aim to improve the quality and quantity of sleep should be an integral part of the comprehensive care provided to individuals with psychosis.

Ahmad Mayeli, PhD, is a postdoctoral research associate at the University of Pittsburgh, Department of Psychiatry, with a specialization in neuroimaging, signal processing, and data analysis. He holds a PhD in Electrical and Computer Engineering from the University of Oklahoma, which focused on developing new approaches to simultaneous EEG-fMRI acquisition, finding objective biomarker for mood and anxiety disorders, and studying fMRI neurofeedback in healthy and depressive individuals. Currently, he is working as a postdoctoral research associate in Dr Fabio Ferrarelli's lab, where he is researching sleep characteristics and circadian rhythm in individuals at clinical high risk for psychosis individuals and patients with schizophrenia and investigating the neurobiology of psychosis.