Clinical evaluation of sleep features and sleep-wake disorders inpatients WHO have been treated in the psychiatric unit

Introduction and Objective: Sleep is an indispensable part of life. Sleep disorders are included in the diagnostic criteria of many disorders in the guidelines for the diagnosis of psychiatric disorders. Sleep disorders may pave the way for the formation of other psychiatric diseases, trigger them, and increase the severity of existing symptoms. Patients admitted to psychiatric inpatient clinics constitute a different group than outpatients. In cases of acute mental crisis, people are restricted to inpatient clinics and treated and followed up. Sleep disorders are quite common in inpatients, with a rate of eight out of ten people. Treatment of sleep disorders is thought to be an important clinical goal to aid recovery, irrespective of psychiatric diagnosis. The aim of this study was to examine the sleep characteristics of patients hospitalized in the psychiatry service and the effects of sleep disorders on the course and treatment of psychiatric disorders. Method: The study was carried out with 90 patients who were hospitalized in the Inpatient Psychiatry Clinic of Recep Tayyip Erdogan University Medical Faculty between 01.02.2020 and 01.01.2022 for follow-up and treatment. The semi-structured information collection form, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Biological Rhythm Assessment Interview (BRAIN), Iowa Sleep Experiences Survey (ISES) were administered to the patients 72-96 hours after their hospitalization by the researcher. At discharge, PSQI, ESS, and ISI were repeated to compare with the initial tests at admission. Patients were classified according to DSM-5 diagnostic criteria as schizophrenia and other psychotic disorders, bipolar and related disorders, depressive disorders, anxiety disorders, and other disorders. During their hospitalization and discharge, the clinical scales specific to the primary diseases already were applied which was also already in the routine clinical procedures. These scales consist of Positive Symptoms Rating Scale (SAPS), Negative Symptoms Rating Scale (SANS), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Scale (HAM-A), Young Mania Rating Scale (YMRS). Obtained data was evaluated using SPSS for Windows 22.0 software programme. Findings: It was found that 87.8% of the hospitalized patients had poor sleep quality during their hospitalization, and the prevalence decreased significantly to 63.3%, with the mean total PUKI scores remaining above the threshold value at discharge. It was determined that those who had poor sleep quality before treatment had lower rates of working at any job, higher number of hospitalizations, and received more hypnotic drugs during their current hospitalization. A family history of sleep disorders was associated with poor sleep quality and insomnia. It was determined that there was an inverse relationship between the irregularity in biological rhythms and sleep quality. It was determined that antipsychotics limited the reduction in daytime sleepiness as measured by ESS. General dream experiences were found to be associated with poor sleep quality. There was no difference between psychiatric diagnoses in terms of sleep problems. In regression analysis, it was determined that daytime dysfunction limited the decrease in YMRS scores. A significant correlation was found between the change in HAM-D scores and poor sleep quality and insomnia. Result: Sleep complaints and sleep disturbances are highly prevalent in patients in psychiatric units, regardless of diagnosis. Appropriate interventions for the modifiable and curable factors in the etiology of sleep problems, which also have a strong biological aspect, can reduce the severity of the clinical manifestation of the primary psychiatric disease and improve functioning in patients Keywords: sleep, sleep disorders, psychiatric disease, inpatient treatment