Sleep and mental disorders: A meta-analysis of polysomnographic research

Psychol Bull. 2016 Sep;142(9):969-990. doi: 10.1037/bul0000053. Epub 2016 Jul 14.


Investigating sleep in mental disorders has the potential to reveal both disorder-specific and transdiagnostic psychophysiological mechanisms. This meta-analysis aimed at determining the polysomnographic (PSG) characteristics of several mental disorders. Relevant studies were searched through standard strategies. Controlled PSG studies evaluating sleep in affective, anxiety, eating, pervasive developmental, borderline and antisocial personality disorders, attention-deficit-hyperactivity disorder (ADHD), and schizophrenia were included. PSG variables of sleep continuity, depth, and architecture, as well as rapid-eye movement (REM) sleep were considered. Calculations were performed with the "Comprehensive Meta-Analysis" and "R" software. Using random effects modeling, for each disorder and each variable, a separate meta-analysis was conducted if at least 3 studies were available for calculation of effect sizes as standardized means (Hedges' g). Sources of variability, that is, sex, age, and mental disorders comorbidity, were evaluated in subgroup analyses. Sleep alterations were evidenced in all disorders, with the exception of ADHD and seasonal affective disorders. Sleep continuity problems were observed in most mental disorders. Sleep depth and REM pressure alterations were associated with affective, anxiety, autism and schizophrenia disorders. Comorbidity was associated with enhanced REM sleep pressure and more inhibition of sleep depth. No sleep parameter was exclusively altered in 1 condition; however, no 2 conditions shared the same PSG profile. Sleep continuity disturbances imply a transdiagnostic imbalance in the arousal system likely representing a basic dimension of mental health. Sleep depth and REM variables might play a key role in psychiatric comorbidity processes. Constellations of sleep alterations may define distinct disorders better than alterations in 1 single variable. (PsycINFO Database Record

Publication types

  • Meta-Analysis
  • Review
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Antisocial Personality Disorder / epidemiology
  • Antisocial Personality Disorder / psychology
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Attention Deficit Disorder with Hyperactivity / psychology
  • Autistic Disorder / epidemiology
  • Autistic Disorder / psychology
  • Borderline Personality Disorder / epidemiology
  • Borderline Personality Disorder / psychology
  • Child Development Disorders, Pervasive / epidemiology
  • Child Development Disorders, Pervasive / psychology
  • Comorbidity
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / psychology
  • Feeding and Eating Disorders / epidemiology
  • Feeding and Eating Disorders / psychology
  • Humans
  • Mental Disorders / epidemiology*
  • Mental Disorders / psychology
  • Mood Disorders / epidemiology
  • Mood Disorders / psychology
  • Polysomnography
  • Schizophrenia / epidemiology
  • Schizophrenic Psychology
  • Sleep Wake Disorders / epidemiology*
  • Sleep Wake Disorders / physiopathology
  • Sleep Wake Disorders / psychology
  • Sleep*
  • Sleep, REM