University of Oulu

Erik Cederlöf, Minna Holm, Markku Lähteenvuo, Willehard Haaki, Jarmo Hietala, Katja Häkkinen, Erkki Isometsä, Tuomas Jukuri, Risto Kajanne, Olli Kampman, Tuula Kieseppä, Kaisla Lahdensuo, Jouko Lönnqvist, Teemu Männynsalo, Jussi Niemi-Pynttäri, Kimmo Suokas, Jaana Suvisaari, Jari Tiihonen, Hannu Turunen, Asko Wegelius, Juha Veijola, Aarno Palotie, Tiina Paunio, Sleep in Psychotic Disorders: Results From Nationwide SUPER Finland Study, Schizophrenia Bulletin Open, Volume 3, Issue 1, January 2022, sgac011,

Sleep in psychotic disorders : results from nationwide SUPER Finland study

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Author: Cederlöf, Erik1,2,3; Holm, Minna1; Lähteenvuo, Markku4,5;
Organizations: 1Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
2Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
3SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
4Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
5Niuvanniemi Hospital, University of Eastern Finland, Finland
6Department of Psychiatry, University of Turku, Turku, Finland
7Department of Psychiatry, Oulu University Hospital, Oulu, Finland
8Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
9Department of Psychiatry, University of Tampere, Tampere, Finland
10Social Services and Health Care Sector; City of Helsinki, Helsinki, Finland
11Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
12Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden
13Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
14Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.8 MB)
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Language: English
Published: Oxford University Press, 2022
Publish Date: 2022-09-22


Objective: Characterizing sleep in patients with schizophrenia, schizoaffective disorder, bipolar disorder, and psychotic depression.

Methods: This cross-sectional questionnaire study is based on the SUPER study sample, which is part of the Stanley Global Neuropsychiatric Genomics Initiative. The study is a multicentre, nationwide Finnish study consisting of patients (N = 8 623) both in primary and specialized health care. The main measurements were sleep duration, difficulties initiating sleep, early morning awakenings, and fatigue. These results were compared with a nationally representative sample of the Finnish population from the Health 2000 survey (N = 7 167) with frequency and logistic regression analyses.

Results: Patients had more sleep problems compared with the general population, especially young and middle-aged patients (Difficulties initiating sleep in young patients odds ratio = 12.3, 95% CI 9.8–15.4). Long sleep duration was the most deviating property of the sleep characteristics, being particularly common among young patients with schizophrenia (odds ratio = 27.9, 95% CI 22.1–35.2, 47.4% vs 3.3% prevalence). All sleep problems were associated with worse subjective health. We also conducted a latent class analysis, resulting in a cluster relatively free of sleep problems (58% of patients), an insomnia symptom cluster (26%), and a hypersomnia symptom cluster (15%).

Conclusions: In our sample, patients with psychotic disorders have more sleep problems—especially long sleep duration but also insomnia symptoms—compared with the general population. The patients can in a latent class analysis of their sleep symptoms be divided into groups with differing sleep profiles.

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Series: Schizophrenia bulletin open
ISSN: 2632-7899
ISSN-E: 2632-7899
ISSN-L: 2632-7899
Volume: 3
Issue: 1
Pages: 1 - 9
DOI: 10.1093/schizbullopen/sgac011
Type of Publication: A1 Journal article – refereed
Field of Science: 3124 Neurology and psychiatry
Funding: This work was supported by the Stanley Center for Psychiatric Research at Broad Institute. MD Cederlöf and Professor Paunio were supported by grants from Finska Läkaresällskapet (#9-1600-15 and #8-1353-9). Dr Minna Holm was supported by a grant from the Academy of Finland (#310295). The work was also supported by the University of Helsinki (TYH20919315). MD Cederlöf received a grant from the Perklén foundation as well (#201700003). The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Copyright information: © The Author(s) 2022. Published by Oxford University Press on behalf of the University of Maryland's school of medicine, Maryland Psychiatric Research Center. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact