Insomnia is frequent in schizophrenia and associated with night eating and obesity
Open accessAbstract
Background Sleep difficulties are common in schizophrenia, however these complaints are often overshadowed by more prominent clinical concerns. The point prevalence of insomnia in this population is not well documented. Poor sleep is associated with lower quality of life, impaired cognition, and weight gain.Objectives The objectives of this study are to evaluate the prevalence of insomnia in schizophrenia and to explore the relationship of sleep to cognition, quality of life, and clinical variables.Method 175 outpatients with schizophrenia or schizoaffective disorder were assessed for insomnia. Participants were evaluated for sleep difficulties, sleep patterns, body mass index, and psychiatric symptoms. Participants were also administered a brief cognitive assessment of processing speed.Results 44% of the sample currently met the criteria for clinical insomnia. An additional 4% were successfully treated with medications. Insomnia was associated with depression and was an independent predictor of lower quality of life. Insomnia was also associated with high rates of night eating and patients with severe insomnia were significantly more obese. The type of antipsychotic did not account for the difference in body mass index. No difference between group means in cognition was detected, although those with severe insomnia did perform least well.Conclusion Clinical insomnia in outpatients with schizophrenia is highly prevalent and has a negative impact on quality of life and psychiatric symptoms. This study offers additional support to the association between poor sleep and higher weight, as well as indicating a potential link to night eating in this population. Assessment for sleep difficulties should be a routine part of clinical care.
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Estimates for the prevalence of clinically significant insomnia among individuals with a diagnosis of schizophrenia vary from 36 to 80%, depending on study recruitment criteria and definition of insomnia used.
“with estimates for the prevalence of clinically significant insomnia among individuals with a diagnosis of schizophrenia varying from 36 to 80%, depending on study recruitment criteria and definition of insomnia used (Freeman et al., 2009, Palmese et al., 2011, Xiang et al., 2009).”
From The role of sleep dysfunction in the occurrence of delusions and hallucinations: A systematic review (2015) · cites this paper as Palmese et al., 2011
Results §3.1 reports that 44% of 175 outpatients with schizophrenia or schizoaffective disorder met criteria for clinical insomnia, supporting a prevalence estimate within the cited range. The paper does not establish the 36–80% range or attribute variation in estimates to recruitment criteria and definitions of insomnia; its Introduction §1 says the point prevalence is not well known. (LLM, conf=0.86)
Experimental — accuracy not yet measuredPalmese et al. (2011) found no correlation between insomnia symptoms and positive symptoms.
“In contrast with the above findings, Palmese et al. (2011) found no correlation between insomnia symptoms and positive symptoms — although insomnia prevalence was again found to be elevated in this group, with only 21% of participants reporting no significant sleep difficulties.”
From The role of sleep dysfunction in the occurrence of delusions and hallucinations: A systematic review (2015) · cites this paper as Palmese et al. (2011)
Sleep dysfunction is extremely common in patients with schizophrenia.
“Sleep dysfunction is extremely common in patients with schizophrenia.”
From The role of sleep dysfunction in the occurrence of delusions and hallucinations: A systematic review (2015) · cites this paper as Palmese et al., 2011
Insomnia prevalence was elevated in this group, with only 21% of participants reporting no significant sleep difficulties.
“although insomnia prevalence was again found to be elevated in this group, with only 21% of participants reporting no significant sleep difficulties.”
From The role of sleep dysfunction in the occurrence of delusions and hallucinations: A systematic review (2015) · cites this paper as Palmese et al. (2011)
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- Authors
- Palmese, L. B., DeGeorge, P. C., Ratliff, J. C., Srihari, V. H., Wexler, B. E., Krystal, A. D., & Tek, C.
- Affiliations
- Yale University (US)
- Duke University (US)
- Corresponding author
- Palmese, Laura B.
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2011-12
- Volume
- 133
- Issue
- 1-3
- Pages
- 238-243
- ISSN
- 0920-9964 (ISSN-L)
- PMC
- PMC5581545
- OpenAlex
- W2104505408
- Cited by
- 138
- References
- 38
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 9 · 2023: 9 · 2022: 8 · 2021: 16 · 2020: 13 · 2019: 12 · 2018: 12 · 2017: 10 · 2016: 8 · 2015: 7 · 2014: 9 · 2013: 6 · 2012: 4
- FWCI
- 7.83
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Sunovion
- National Institute of Mental Health (RC1MH088971)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- insomnia, schizophrenia
- MeSH terms
- Adult, Eating, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Obesity, Psychiatric Status Rating Scales, Surveys and Questionnaires, Schizophrenia, Schizophrenic Psychology, Severity of Illness Index, Body Mass Index, Prevalence
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