Extracting Circadian and Sleep Parameters from Longitudinal Data in Schizophrenia for the Design of Pragmatic Light Interventions
2022 (Engelska)Ingår i: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 48, nr 2, s. 447-456Artikel i tidskrift (Refereegranskat) Published
Abstract [en]
Sleep and circadian rhythm dysfunction is prevalent in schizophrenia, is associated with distress and poorer clinical status, yet remains an under-recognized therapeutic target. The development of new therapies requires the identification of the primary drivers of these abnormalities. Understanding of the regulation of sleep-wake timing is now sufficiently advanced for mathematical model-based analyses to identify the relative contribution of endogenous circadian processes, behavioral or environmental influences on sleep-wake disturbance and guide the development of personalized treatments. Here, we have elucidated factors underlying disturbed sleep-wake timing by applying a predictive mathematical model for the interaction of light and the circadian and homeostatic regulation of sleep to actigraphy, light, and melatonin profiles from 20 schizophrenia patients and 21 age-matched healthy unemployed controls, and designed interventions which restored sleep-circadian function. Compared to controls, those with schizophrenia slept longer, had more variable sleep timing, and received significantly fewer hours of bright light (light > 500 lux), which was associated with greater variance in sleep timing. Combining the model with the objective data revealed that non 24-h sleep could be best explained by reduced light exposure rather than differences in intrinsic circadian period. Modeling implied that late sleep offset and non 24-h sleep timing in schizophrenia can be normalized by changes in environmental light-dark profiles, without imposing major lifestyle changes. Aberrant timing and intensity of light exposure patterns are likely causal factors in sleep timing disturbances in schizophrenia. Implementing our new model-data framework in clinical practice could deliver personalized and acceptable light-dark interventions that normalize sleep-wake timing.
Ort, förlag, år, upplaga, sidor
Oxford University Press, 2022. Vol. 48, nr 2, s. 447-456
Nyckelord [en]
clinical predictive framework, entrainment by light, light therapy design, mathematical model, model-data fusion, transdiagnostic psychiatry
Nationell ämneskategori
Psykiatri Neurovetenskaper
Identifikatorer
URN: urn:nbn:se:umu:diva-193004DOI: 10.1093/schbul/sbab124ISI: 000763968400001PubMedID: 34757401Scopus ID: 2-s2.0-85125553047OAI: oai:DiVA.org:umu-193004DiVA, id: diva2:1644393
Forskningsfinansiär
Knut och Alice Wallenbergs Stiftelse2022-03-142022-03-142023-09-05Bibliografiskt granskad