Sleep alterations in patients with Catatonia: A scoping review and a case illustration

Catatonia is a transdiagnostic syndrome that remains insufficiently recognized despite its clinical impact. Although sleep disturbances are well documented in mood and psychotic disorders, their association with catatonia has only rarely been described. This study aimed to map the available evidence on objective sleep alterations in patients with catatonia, complemented by an illustrative clinical case. A scoping review was conducted in accordance with the PRISMA extension for Scoping Reviews (PRISMA-ScR). Electronic databases were searched in July 2026 for studies reporting objective overnight sleep assessments in patients with catatonia. An illustrative case assessed with polysomnography and psychometric measures was included to contextualize the findings. Six studies met the inclusion criteria, including five case reports describing nine patients and one observational study including three patients with catatonic schizophrenia. Across studies, catatonia was associated with heterogeneous alterations in sleep architecture, while autonomic abnormalities were occasionally reported. In the presented case, polysomnography showed disrupted sleep architecture dominated by N1 and N2 sleep, reduced N3 and REM sleep, and marked sleep fragmentation with frequent micro-arousals. Overall, the available evidence suggests that sleep disturbances may accompany catatonic states. However, the current evidence base remains extremely limited and heterogeneous, precluding any conclusion regarding the specificity of these findings to catatonia or their underlying mechanisms. Further studies using contemporary polysomnographic methods are needed to clarify the clinical and pathophysiological significance of sleep alterations in catatonia.