[Psychotic disorders and sleep disorders: A review]

Context Psychotic disorders are severe mental disorders that can cause a loss of contact with reality. Along with positive symptoms (delusions and hallucinations), they also encompass many other dysfunctions, such as sleep problems, which themselves can cause great distress and impairment in patients. Objective To review current literature on the relationship between sleep disorders and psychosis, on the clinical impact of such a relationship, and the psychological treatment of sleep disorders in the context of psychosis. Method Narrative overview of the literature synthesizing the findings about the relationship between psychosis and sleep disorders, and the psychological treatment of the latter, retrieved from searches of computerized databases, hand searches, and authoritative texts. Results Evidence shows a bidirectional relationship between psychosis and sleep disorders. Despite many hypotheses involving genetics, hormones, or neuronal functions regarding the nature of this association, the exact mechanism remains elusive. However, sleep-related problems are an interesting therapeutic target to improve quality of life and psychotic symptoms and respond well to psychological interventions. Conclusion Patients with psychotic disorders can benefit from CBT for insomnia, given a few adaptations to existing protocols. Additional studies are necessary to determine which patients are most likely to benefit from such interventions and to clarify the relationship between psychosis and sleep disorders, and the clinical implications of them co-existing.