Study of quality of sleep in patients with psychiatric illness under remission in relation to quality of life and functional disability

  • Siva Anoop Yella ESIC Medical College and Hospital
  • Ramasubba Reddy Institute of Mental Health
  • P. C. B. Gupta Institute of Mental Health
Keywords: psychiatric disorders, quality of sleep, quality of life, functional disability


Sleep is one of the essential biological rhythms of a human being. Sleep disturbances could precipitate psychiatric illnesses like schizophrenia, bipolar affective disorder, depression, anxiety disorders, substance use disorders, etc. Even when psychiatric disorders are successfully treated, sleep disturbances often fail to remit. The quality of sleep in such patients is badly affected and influences the daytime functioning and impairs the overall quality of life.

The aim of the study. To study quality of sleep of patients with psychiatric illness under remission in relation to quality of life and functional disability.

Material and methods. Patients attending the review outpatient department of Tertiary hospital are selected for the study. Patients diagnosed with bipolar affective disorder and schizophrenia according to ICD-10 criteria were taken. Patients meeting remission criteria for bipolar affective disorder i.e., YMRS score </=8, MADRS score </=10 and for schizophrenia –eight PANSS signs and symptoms score <3 are selected from them. Quality of sleep is compared with quality of life and functional disability.

Results: Mean age was found to be 36.59. Mean PSQI score is 8.35. The mean score of physical quality of life domain is 58.28, mean score of psychological quality of life domain is 56.63, mean score of social quality of life domain is 55.39, and mean score of environmental quality of life domain is 55.41. Mean score of functional disability score is 30.14.

Conclusion: Poor quality of sleep in Schizophrenia and BPAD needs to be addressed.


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Author Biographies

Siva Anoop Yella, ESIC Medical College and Hospital

Department of Psychiatry

Ramasubba Reddy, Institute of Mental Health

Department of Psychiatry

P. C. B. Gupta, Institute of Mental Health

Department of Psychiatry


Soehner, A. M., Kaplan, K. A., Harvey, A. G. (2013). Insomnia Comorbid to Severe Psychiatric Illness. Sleep Medicine Clinics, 8 (3), 361–371. doi:
ICD-10 Classification of Mental and Behavioral Disorders, Clinical Descriptions and Diagnostic Guideline (1992). Geneva: WHO. Available at:
Hirschfeld, R. M., Calabrese, J. R., Frye, M. A., Lavori, P. W., Sachs, G., Thase, M. E., Wagner, K. D. (2007). Defining the clinical course of bipolar disorder: response, remission, relapse, recurrence, and roughening. Psychopharmacol Bull, 40 (3), 7–14.
Adriane M Soehnera, J. C. K. (2015). A Retrospective Examination of Sleep Disturbance across the Course of Bipolar Disorder. Journal of Sleep Disorders & Therapy, 4 (2). doi:
Boland, E. M., Stange, J. P., Molz Adams, A., LaBelle, D. R., Ong, M.-L., Hamilton, J. L. et. al. (2015). Associations between sleep disturbance, cognitive functioning and work disability in Bipolar Disorder. Psychiatry Research, 230 (2), 567–574. doi:
Kanady, J. C., Soehner, A. M., Klein, A. B., Harvey, A. G. (2017). The association between insomnia-related sleep disruptions and cognitive dysfunction during the inter-episode phase of bipolar disorder. Journal of Psychiatric Research, 88, 80–88. doi:
Grandner, M. A., Chakravorty, S. (2017). Insomnia in Primary Care: Misreported, Mishandled, and Just Plain Missed. Journal of Clinical Sleep Medicine, 13 (8), 937–939. doi:
Faulkner, S., Bee, P. (2017). Experiences, perspectives and priorities of people with schizophrenia spectrum disorders regarding sleep disturbance and its treatment: a qualitative study. BMC Psychiatry, 17 (1). doi:
Baandrup, L., Jennum, P., Lublin, H., Glenthoj, B. (2012). Treatment options for residual insomnia in schizophrenia. Acta Psychiatrica Scandinavica, 127 (1), 81–82. doi:
Andreasen, N. C., Carpenter, W. T., Kane, J. M., Lasser, R. A., Marder, S. R., Weinberger, D. R. (2005). Remission in Schizophrenia: Proposed Criteria and Rationale for Consensus. American Journal of Psychiatry, 162 (3), 441–449. doi:
“Reproduced with permission from the World Health Organization (WHO) (2004). WHO does not endorse any specific companies, products or services.” World health Organization,. Quality of Life (WHOQOL)-BREF. Geneva.
Van Os, J., Drukker, M., à Campo, J., Meijer, J., Bak, M., Delespaul, P. (2006). Validation of Remission Criteria for Schizophrenia. American Journal of Psychiatry, 163 (11), 2000–2002. doi:
Yeomans, D., Taylor, M., Currie, A., Whale, R., Ford, K., Fear, C. et. al. (2010). Resolution and remission in schizophrenia: getting well and staying well. Advances in Psychiatric Treatment, 16 (2), 86–95. doi:
Tharoor, H., Chauhan, A., Sharma, P. V. N. (2008). A cross-sectional comparison of disability and quality of life in euthymic patients with bipolar affective or recurrent depressive disorder with and without comorbid chronic medical illness. Indian Journal of Psychiatry, 50 (1), 24. doi:
Yatham, L. N., Michalakee, I. G., Lam, R. W. (2003). Quality of life in bipolar disorder: A review of literature, poster presentation. Bipolar Disorders S, 1 (5).
Gershon, E. S., Guroff, J. J. (1984). Information from relatives: diagnosis of affective disorders. Archives of General Psychiatry, 41 (2), 173–180. doi:
Talbot, L. S., Stone, S., Gruber, J., Hairston, I. S., Eidelman, P., Harvey, A. G. (2012). A test of the bidirectional association between sleep and mood in bipolar disorder and insomnia. Journal of Abnormal Psychology, 121 (1), 39–50. doi:
Royuela, A., Macias, J. A., Gil-Verona, J. A., et. al. (2002). Sleep in schizophrenia: a preliminary study using the Pittsburgh Sleep Quality Index. Neurobiol Sleep Wakefulness Cycle, 2 (2), 37–39.
Benca, R. M., Obermeyer, W. H., Thisted, R. A., Gillin, J. C. (1992). Sleep and psychiatric disorders: a meta-analysis. Archives of general psychiatry, 49 (8), 651–668. doi:
Haffmans, P. M. J., Hoencamp, E., Knegtering, H. J., van Heycop ten Ham, B. F. (1994). Sleep disturbance in schizophrenia. British Journal of Psychiatry, 165 (5), 697–698. doi:
Palmese, L. B., DeGeorge, P. C., Ratliff, J. C., Srihari, V. H., Wexler, B. E., Krystal, A. D., Tek, C. (2011). Insomnia is frequent in schizophrenia and associated with night eating and obesity. Schizophrenia Research, 133 (1-3), 238–243. doi:
Ritsner, M., Kurs, R., Ponizovsky, A., Hadjez, J. (2004). Perceived quality of life in schizophrenia: Relationships to sleep quality. Quality of Life Research, 13 (4), 783–791. doi:
Chan, M.-S., Chung, K.-F., Yung, K.-P., Yeung, W.-F. (2017). Sleep in schizophrenia: A systematic review and meta-analysis of polysomnographic findings in case-control studies. Sleep Medicine Reviews, 32, 69–84. doi:
Cohrs, S. (2008). Sleep Disturbances in Patients with Schizophrenia. CNS Drugs, 22 (11), 939–962. doi:
Krishna, P., Shwetha, S. (2008). Sleep Quality and Correlates of Sleep Among Medical Students. Indian Journal of Sleep Medicine, 3 (2), 58–61. doi:
Yogesh, S., Abha, S., Priyanka, S. (2014). Short Communication Mobile usage and sleep patterns among medical students. Indian Journal of Physiology and Pharmacology, 58 (1), 100–103.
Fortier-Brochu, É., Beaulieu-Bonneau, S., Ivers, H., Morin, C. M. (2012). Insomnia and daytime cognitive performance: A meta-analysis. Sleep Medicine Reviews, 16 (1), 83–94. doi:
Morin, C. M., Blais, F., Savard, J. (2002). Are changes in beliefs and attitudes about sleep related to sleep improvements in the treatment of insomnia? Behaviour Research and Therapy, 40 (7), 741–752. doi:
Gruber, J., Harvey, A. G., Wang, P. W., Brooks, J. O., Thase, M. E., Sachs, G. S., Ketter, T. A. (2009). Sleep functioning in relation to mood, function, and quality of life at entry to the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Journal of Affective Disorders, 114 (1-3), 41–49. doi:
Cotrena, C., Branco, L. D., Kochhann, R., Shansis, F. M., Fonseca, R. P. (2016). Quality of life, functioning and cognition in bipolar disorder and major depression: A latent profile analysis. Psychiatry Research, 241, 289–296. doi:
Kleinman, L., Buysse, D. J., Harding, G., Lichstein, K., Kalsekar, A., Roth, T. (2011). Patient-Reported Outcomes in Insomnia: Development of a Conceptual Framework and Endpoint Model. Behavioral Sleep Medicine, 11 (1), 23–36. doi:
Bastien, C. H., Vallières, A., Morin, C. M. (2001). Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Medicine, 2 (4), 297–307. doi:
Buysse, D. J., Yu, L., Moul, D. E., Germain, A., Stover, A., Dodds, N. E. et. al. (2010). Development and Validation of Patient-Reported Outcome Measures for Sleep Disturbance and Sleep-Related Impairments. Sleep, 33 (6), 781–792. doi:
Sylvia, L. G., Dupuy, J. M., Ostacher, M. J., Cowperthwait, C. M., Hay, A. C., Sachs, G. S. et. al. (2011). Sleep disturbance in euthymic bipolar patients. Journal of Psychopharmacology, 26 (8), 1108–1112. doi:
Plante, D. T., Winkelman, J. W. (2008). Sleep Disturbance in Bipolar Disorder: Therapeutic Implications. American Journal of Psychiatry, 165 (7), 830–843. doi:
Giglio, L. M. F., Andreazza, A. C., Andersen, M., Ceresér, K. M., Walz, J. C., Sterz, L., Kapczinski, F. (2008). Sleep in bipolar patients. Sleep and Breathing, 13 (2), 169–173. doi:
Young, R. C., Biggs, J. T., Ziegler, V. E., Meyer, D. A. (1978). A Rating Scale for Mania: Reliability, Validity and Sensitivity. British Journal of Psychiatry, 133 (5), 429–435. doi:
Montgomery, S. A., Åsberg, M. (1979). A New Depression Scale Designed to be Sensitive to Change. British Journal of Psychiatry, 134 (4), 382–389. doi:
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., Kupfer, D. J. (1989). The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Research, 28 (2), 193–213. doi:
“Reproduced with permission from the World Health Organization (WHO) (2000). WHO does not endorse any specific companies, products or services.” World Health Organization, Disability Assessment Schedule II (WHO-DAS II). Geneva.
Dahl, R. E., Ryan, N. D., Matty, M. K., Birmaher, B., Al-Shabbout, M., Williamson, D. E., Kupfer, D. J. (1996). Sleep onset abnormalities in depressed adolescents. Biological Psychiatry, 39 (6), 400–410. doi:
Harvey, A. G., Schmidt, D. A., Scarnà, A., Semler, C. N., Goodwin, G. M. (2005). Sleep-Related Functioning in Euthymic Patients With Bipolar Disorder, Patients With Insomnia, and Subjects Without Sleep Problems. American Journal of Psychiatry, 162 (1), 50–57. doi:
Hofstetter, J. R., Lysaker, P. H., Mayeda, A. R. (2005). Quality of sleep in patients with schizophrenia is associated with quality of life and coping. BMC Psychiatry, 5 (1). doi:
Rehman, A., Waite, F., Sheaves, B., Biello, S., Freeman, D., Gumley, A. (2016). Clinician perceptions of sleep problems, and their treatment, in patients with non-affective psychosis. Psychosis, 9 (2), 129–139. doi:
Kalucy, M. J., Grunstein, R., Lambert, T., Glozier, N. (2013). Obstructive sleep apnoea and schizophrenia – A research agenda. Sleep Medicine Reviews, 17 (5), 357–365. doi:
Zeitlhofer, J., Schmeiser-Rieder, A., Tribl, G., Rosenberger, A., Bolitschek, J., Kapfhammer, G. et. al. (2000). Sleep and quality of life in the Austrian population. Acta Neurologica Scandinavica, 102 (4), 249–257. doi:
Müller, M. J., Olschinski, C., Kundermann, B., Cabanel, N. (2016). Subjective sleep quality and sleep duration of patients in a psychiatric hospital. Sleep Science, 9(3), 202–206. doi:
Benca, R. M.; Kryger, M. H., Roth, T., Dement, W. C. (Eds.) (2000). Mood disorders. Principles and practice of sleep medicine. Philadelphia: WB Saunders, 1140–1157.
Wooten, V. D., Buysse, D. J. (1999). Sleep in psychiatric disorders. In: Sleep disorders medicine: basic science, technical considerations and clinical aspects. New York: Butterworth-Heinemann, 573–586.
Monti, J. M., Monti, D. (2004). Sleep in schizophrenia patients and the effects of antipsychotic drugs. Sleep Medicine Reviews, 8 (2), 133–148. doi:
Benson, K. L., Zarcone, Jr. V. P. (2000). Schizophrenia. Principles and practice of sleep medicine. Philadelphia: WB Saunders, 1159–1167.
Klingaman, E. A., Palmer-Bacon, J., Bennett, M. E., Rowland, L. M. (2015). Sleep Disorders Among People With Schizophrenia: Emerging Research. Current Psychiatry Reports, 17 (10). doi:
Rotenberg, P., Indurski, R., Kimhi, J., Hadjez, Y., Gutman, E., Shamir, Y. et. al. (2000). The relationship between objective sleep variables and subjective sleep estimation in schizophrenia. International journal of psychiatry in clinical practice, 4 (1), 63–67. doi:
Barclay, N. L., Gehrman, P. R., Gregory, A. M., Eaves, L. J., Silberg, J. L. (2015). The Heritability of Insomnia Progression during Childhood/Adolescence: Results from a Longitudinal Twin Study. Sleep, 38 (1), 109–118. doi:
Heath, A. C., Kendler, K. S., Eaves, L. J., Martin, N. G. (1990). Evidence for Genetic Influences on Sleep Disturbance and Sleep Pattern in Twins. Sleep, 13 (4), 318–335. doi:
Riemann, D., Voderholzer, U., Spiegelhalder, K., Hornyak, M., Buysse, D. J., Nissen, C. et. al. (2007). Chronic Insomnia and MRI-Measured Hippocampal Volumes: A Pilot Study. Sleep, 30 (8), 955–958. doi:
Noh, H. J., Joo, E. Y., Kim, S. T., Yoon, S. M., Koo, D. L., Kim, D. et. al. (2012). The Relationship between Hippocampal Volume and Cognition in Patients with Chronic Primary Insomnia. Journal of Clinical Neurology, 8 (2), 130. doi:
Neylan, T. C., Mueller, S. G., Wang, Z., Metzler, T. J., Lenoci, M., Truran, D. et. al. (2010). Insomnia Severity Is Associated with a Decreased Volume of the CA3/Dentate Gyrus Hippocampal Subfield. Biological Psychiatry, 68 (5), 494–496. doi:
Palagini, L., Biber, K., Riemann, D. (2014). The genetics of insomnia – Evidence for epigenetic mechanisms? Sleep Medicine Reviews, 18 (3), 225–235. doi:

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How to Cite
Yella, S. A., Reddy, R., & Gupta, P. C. B. (2022). Study of quality of sleep in patients with psychiatric illness under remission in relation to quality of life and functional disability. EUREKA: Health Sciences, (2), 29-54.
Medicine and Dentistry