Sleep Disturbances, Psychosis Symptoms, and Suicidal Ideation in First Episode Psychosis: An Exploratory...

Area of Science:

• Psychiatry
• Neuroscience
• Sleep Medicine

Background:

• Sleep disturbances are a significant risk factor for suicidal ideation.
• Individuals experiencing psychosis, particularly first episode psychosis (FEP), have an elevated suicide risk.
• Understanding the intricate relationship between sleep and suicidality in FEP is crucial for effective intervention and risk management.

Purpose of the Study:

• To explore the associations between sleep, psychosis symptoms, and suicidal ideation in individuals with FEP.
• To investigate the subjective experiences and perceptions of individuals with FEP regarding sleep disturbances and suicidality.
• To inform clinical practice and future research directions for managing suicide risk in early psychosis.

Main Methods:

• Recruitment of ten participants experiencing FEP from Early Intervention services.
• Objective sleep monitoring using actigraphy for 7 days.
• Subjective assessments including the Insomnia Severity Index, Prodromal Questionnaire Brief, and Beck Scale for Suicidal Ideation, complemented by semi-structured interviews.

Main Results:

• No statistically significant associations were found between sleep variables, psychosis symptoms, and suicidal ideation.
• Descriptive data revealed considerable variation in sleep duration, timing, wake after sleep onset, and sleep onset latency among participants.
• Qualitative findings highlighted participants' experiences of sleep loss as a precursor to "losing themselves," impaired decision-making, and a perceived "trigger" for psychosis.

Conclusions:

• While quantitative associations were not significant, qualitative data underscore the profound impact of sleep disturbances on the lived experience of FEP.
• Participants linked poor sleep to reduced emotional control, increased self-harming behaviors, and viewed suicide as an escape from distressing sleep-related experiences.
• Further research is warranted to elucidate the complex psychological processes underlying the relationship between specific sleep disturbances and suicidality in FEP.