Potential Sleep Categories And Their Relationship With Relapse In Patients With Schizophrenia

Objective Investigated sleep subtypes in patients with schizophrenia,define different sleep classes in sociology of population data,clinical variables,negative emotions,performance characteristics.The correlation between each potential class and relapse of schizophrenia was analyzed,and the feelings of sleep disorders and the influencing factors of schizophrenia patients were further explored by adopting qualitative research,so as to provide a theoretical basis for identifying the key intervention groups and implementing personalized sleep intervention.Methods This study includes quantitative study and qualitative study.Quantitative study: This was a cross-sectional study of 330 schizophrenic patients who met inclusion and exclusion criteria in two psychiatric hospitals in Hunan and Ningxia.Demographic and sociological data of patients were designed,and the Pittsburgh Sleep Quality Index(PSQI),Depression-Anxiety-Stress Scale(DAS-21)and Concise Psychiatric Rating Scale(BPRS)were selected to investigate demographic data,the sleep,negative emotions and severity of psychiatric symptoms in patients with schizophrenia.MPLUS 7.0 and SPSS22.0 were used to analyze the data.Descriptive analysis to explore the demographic and sociological characteristics,clinical disease characteristics and sleep status of patients with schizophrenia.The latent profile analysis was used to fit the sleep potential categories of patients with schizophrenia.One-way ANOVA,chi-square test and multiple Logistic regression analysis were used to analyze the characteristics of sleep potential categories.Pearson correlation analysis was used to explore the correlation between the sleep potential categories of patients and disease recurrence.Qualitative study: In this study,22 schizophrenics who complain of sleep problems and have completed the preliminary questionnaire were selected for semi-structured in-depth interviews by the method of objective sampling in the principle of convenience.The interview data were analyzed by Nvivo12.0 qualitative analysis software and Colaizzi phenomenological analysis method.Results 1.Among the 330 schizophrenics enrolled,123(37.3%)patients reported poor sleep quality,and 64.5% of the schizophrenics with sleep disorders.2.Through the latent profile analysis,the sleep of patients with schizophrenia could be divided into three potential categories: "less sleep problems group"(C1),accounting for 60.4%of the total;"Group with typical insomnia and using sleeping drugs"(C2),accounting for 16.1%of the total;"Had difficulty falling asleep and did not use sleeping drugs,"(C3)accounting for23.5 percent of the total.3.The results of multiple Logistic regression showed that there were statistical differences in age,BPRS positive symptom score,depression,anxiety and stress among patients with different sleep potential categories(P<0.05).Older schizophrenia patients were more likely to be in the "typical insomnia and use of sleeping drugs group"(C2);The more severe the stress and anxiety,the more severe the BPRS positive symptoms of schizophrenia patients were more likely to appear in the "typical insomnia and use of sleeping drugs group"(C2)and "difficulty in falling asleep and do not use sleeping drugs group"(C3);Patients with more severe depressive symptoms were more likely to be in the "difficulty falling asleep and not using sleeping drugs" group(C3).4.Chi-square test results showed that different sleep potential categories in patients with schizophrenia were correlated with disease recurrence.Schizophrenics with "typical insomnia and use of sleeping drugs"(C2)and "difficulty falling asleep and use of sleeping drugs"(C3)had significantly higher relapse rates than those with "less sleep problems"(C1).5.Six themes and five sub-themes were extracted from qualitative interviews on the experience of sleep disorders and thier influencing factors in patients with schizophrenia:(1)the experience of sleep disorders was summarized into three themes:(1)Increased sleep pressure;(2)Guilt and worry affect others;(3)Changing in daytime functional status.(2)The influencing factors of sleep disorders can be summarized into three themes:(1)Mental state change;(2)Excessive psychological burden;(3)Weak support system.Conclusion 1.People with schizophrenia have poorer sleep quality,the total sleep time is significantly more than the general population,the sleep onset latency is longer,the sleep efficiency is lower,and the occurrence of sleep disorders is more patients.2.The sleep of patients with schizophrenia can be divided into three potential categories: "group with few sleep problems","group with typical insomnia and using sleeping pills",and "group with difficulty falling asleep and not using sleeping pills".3.The age,BPRS positive symptom scores,depression,anxiety and stress of schizophrenics were different among different sleep potential categories.4.Different types of sleep potential in patients with schizophrenia are associated with disease recurrence.5.Schizophrenics accompanied by sleep disorders have a variety of sleep pressure and psychological load.