Sleep and schizophrenia spectrum

The relationships between sleep disorders and psychotic disorders, particularly schizophrenia, are extensively documented in the literature due to their shared diagnostic, prognostic, and therapeutic implications. This chapter examines the relationships between sleep medicine and schizophrenia spectrum disorders, as well as the clinical high-risk (CHR) state. Sleep disorders such as insomnia, restless legs syndrome, sleep apnea, and circadian rhythm disturbances can exacerbate psychotic symptoms, negatively impacting quality of life and treatment response. Conversely, psychotic symptoms, along with certain treatments associated with these conditions, may worsen sleep disturbances. We discuss the implications of early intervention in preventing progression toward psychotic disorders, highlighting sleep as both a predictor and a potential therapeutic target. We also present general principles for managing sleep disturbances associated with psychotic disorders. The management of sleep in patients with psychotic disorders requires a personalized approach, integrating both pharmacological and non-pharmacological strategies.