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Cited by 1,074Sleep and related disordersSleep and Wakefulness ResearchObstructive Sleep Apnea Research

The DOI matches its Crossref record; 366 of the 367 references it cites were found in a registry or an index; none of the 64 sources its claims cite is checked for support yet.

Sleep and mental disorders: a meta-analysis of polysomnographic research

Open access
Baglioni, Chiara, Nanovska, Svetoslava, Regen, Wolfram, Spiegelhalder, Kai, Feige, Bernd, Nissen, Christoph, Reynolds, Charles F., Riemann, Dieter·2016·Psychological Bulletin
DOI 10.1037/bul0000053PMC PMC5110386
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Abstract

Investigating sleep in mental disorders has the potential to reveal both disorder-specific and transdiagnostic psychophysiological mechanisms. This meta-analysis aimed at determining the polysomnographic (PSG) characteristics of several mental disorders. Relevant studies were searched through standard strategies. Controlled PSG studies evaluating sleep in affective, anxiety, eating, pervasive developmental, borderline and antisocial personality disorders, attention-deficit-hyperactivity disorder (ADHD), and schizophrenia were included. PSG variables of sleep continuity, depth, and architecture, as well as rapid-eye movement (REM) sleep were considered. Calculations were performed with the "Comprehensive Meta-Analysis" and "R" software. Using random effects modeling, for each disorder and each variable, a separate meta-analysis was conducted if at least 3 studies were available for calculation of effect sizes as standardized means (Hedges' g). Sources of variability, that is, sex, age, and mental disorders comorbidity, were evaluated in subgroup analyses. Sleep alterations were evidenced in all disorders, with the exception of ADHD and seasonal affective disorders. Sleep continuity problems were observed in most mental disorders. Sleep depth and REM pressure alterations were associated with affective, anxiety, autism and schizophrenia disorders. Comorbidity was associated with enhanced REM sleep pressure and more inhibition of sleep depth. No sleep parameter was exclusively altered in 1 condition; however, no 2 conditions shared the same PSG profile. Sleep continuity disturbances imply a transdiagnostic imbalance in the arousal system likely representing a basic dimension of mental health. Sleep depth and REM variables might play a key role in psychiatric comorbidity processes. Constellations of sleep alterations may define distinct disorders better than alterations in 1 single variable. (PsycINFO Database Record

Overview

Integrity signals

Registry

Crossref · 10.1037/bul0000053

Cites

366 of 366 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

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Claims the paper makes

0 of 64 cited sources checked · 0 supported · 0 flagged

Show all 94 claims

  • Borderline: one of the tests for a substantial claim is unclear. 2
  • It may state two separate claims as one. 64
  • Probably not a substantial claim. 60
115 of 115

  • The paper relies on this without support.

    The sleep characteristics of mental disorders have not been sufficiently described, with data limited by methodological variance for major depression and scarce for most other disorders.

    “Surprisingly, however, sleep characteristics of mental disorders have not yet been sufficiently described, with data being either limited by methodological variance as for major depression or scarce as for most other disorders.”

  • The paper relies on this without support.

    Comorbidity is more often the rule than the exception in clinical settings, so many patients with depression have mixed clinical profiles.

    “Comorbidity being rather the rule than the exception in clinical settings, it is likely that many patients with depression present mixed clinical profiles.”

  • The paper relies on this without support.

    Apart from schizophrenia, sleep characteristics of mental disorders other than major depression have been little investigated.

    “Moreover, apart from this relevant work on sleep in patients with schizophrenia, sleep characteristics associated with mental disorders different from major depression have been little investigated.”

  • The paper relies on this without support.

    Whether sleep variables represent genetic or biological markers of distinct mental disorders remains unclear.

    “Thus, the answer to the question whether sleep variables represent genetic/biological markers of distinct mental disorders is still not clear.”

  • The authors state this as an assumption.

    Each sleep variable could be specifically altered in one disorder only.

    “Based on the endophenotypic approach, each sleep variable could be specifically altered in one disorder only.”

  • The paper relies on this without support.

    Sleep-related neural pathways are closely connected and partly overlap with pathways that regulate affect, cognition, and other important brain functions.

    “Sleep neural pathways are closely connected and in part overlap with neural pathways regulating affect, cognition and other important brain functions.”

  • The paper relies on this without support.

    A strict categorical approach in psychopathology underestimates reciprocal influences among neuropsychobiological mechanisms.

    “The strict categorical approach in psychopathology underestimates the reciprocal influences of neuropsychobiological mechanisms.”

  • The paper relies on this without support.

    Comorbidity is the rule rather than the exception in mental disorders.

    “Comorbidity is indeed the rule and not the exception in mental disorders”

  • The paper relies on this without support.

    ADHD is associated with hypoarousal rather than hyperarousal.

    “ADHD being a disorder associated with rather hypoarousal instead of hyperarousal”

  • The paper relies on this without support.

    Sleep is related to developmental outcomes, including brain maturation, learning, memory, temperament, emotional regulation, relational skills, and physical wellbeing.

    “Sleep has been related to development’s outcomes, being linked to brain maturation, learning, memory, temperament, emotional regulation, relational skills, and physical wellbeing.”

  • The paper relies on this without support.

    Interventions in early age may have a large impact across the lifespan.

    “interventions in early age may have a great impact across the life-span.”

  • The paper relies on this without support.

    PSG studies are unlikely to omit negative findings for single variables because it is common to include a table of means and standard deviations for common sleep variables.

    “PSG studies unlikely do not report negative findings for single variables, as it is common use to include in the manuscript a table with means and standard deviations value for a list of common sleep variables.”

  • The paper relies on this without support.

    Sleep architecture and REM variables are related to cognitive and emotional functioning.

    “As sleep architecture and REM variables are related with cognitive and emotional functioning”

  • The paper relies on this without support.

    There is high comorbidity between schizophrenia and depression.

    “the high comorbidity between schizophrenia and depression”

  • The paper relies on this without support.

    There is a longitudinal association between insomnia and depression and mental disorders in general.

    “considering the longitudinal association between insomnia and depression and mental disorders in general”
15 of 15

Claims other papers make about this one

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Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Schizophrenia REM-latency direction reverses

    Major

    The results describe longer REM latency in schizophrenia, whereas the disorder-specific discussion says it was reduced. These are opposite directions for the same reported finding.

  • Panic disorder is omitted from the continuity exceptions

    Minor

    The results explicitly exclude panic disorder from disorders with a sleep-continuity disturbance, but the discussion names only ADHD and seasonal affective disorder as exceptions.

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Metadata

Authors
Baglioni, C., Nanovska, S., Regen, W., Spiegelhalder, K., Feige, B., Nissen, C., Reynolds, C. F., & Riemann, D.
Affiliations
  • University of Freiburg (DE)
  • University of Pittsburgh (US)
ORCID
Venue
Psychological Bulletin
Publisher
American Psychological Association (APA)
Published
2016-09
Volume
142
Issue
9
Pages
969-990
ISSN
  • 0033-2909 (ISSN-L)
  • 1939-1455
DOI
10.1037/bul0000053
PMC
PMC5110386
OpenAlex
W2469994275
Cited by
1,074
References
367
Citations by year
2026: 121 · 2025: 152 · 2024: 148 · 2023: 125 · 2022: 151 · 2021: 122 · 2020: 113 · 2019: 70 · 2018: 42 · 2017: 28 · 2016: 2
FWCI
6.21
Type
journal article
Language
en
Open access
Licence
Locations
  • Psychological Bulletin (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • University Medical Center of Freiburg
  • National Institute of Mental Health (P30 MH90333)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
  • Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
Keywords
sleep, mental illness, polysomnography, sleep continuity, sleep depth, REM sleep, transdiagnostic mechanisms, psychiatric comorbidity, mood disorders, anxiety disorders, autism spectrum disorder, schizophrenia, attention deficit hyperactivity disorder, pervasive developmental disorders, borderline personality disorder, antisocial personality disorder, eating disorders, arousal system
MeSH terms
Antisocial Personality Disorder, Anxiety Disorders, Feeding and Eating Disorders, Attention Deficit Disorder with Hyperactivity, Autistic Disorder, Mental Disorders, Borderline Personality Disorder, Child Development Disorders, Pervasive, Major Depressive Disorder, Humans, Schizophrenia, Schizophrenic Psychology, Sleep, Sleep Wake Disorders, Sleep, REM, Comorbidity, Polysomnography, Mood Disorders

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