# Association between pharmacological guideline adherence and actigraphy‐measured sleep variables in long‐term hospitalized patients with schizophrenia

## TL;DR

This study found that following schizophrenia treatment guidelines is linked to longer sleep times in hospitalized patients, but the effect does not last over time.

## Contribution

The study is the first to link pharmacological guideline adherence with actigraphy-measured sleep in schizophrenia patients.

## Key findings

- Higher guideline adherence was associated with increased total sleep time in hospitalized patients with schizophrenia.
- No significant longitudinal effects of guideline adherence on sleep parameters were observed over 6 months.
- Hypnotic use did not significantly affect sleep outcomes in this study.

## Abstract

Improving sleep quality is a crucial clinical objective in schizophrenia care; however, the association between evidence‐based pharmacological treatment and sleep outcomes remains unclear. This study aimed to examine whether guideline adherence, assessed using the individual fitness score (IFS), correlated with actigraphy‐measured sleep in long‐term hospitalized patients.

We included 40 inpatients aged <65 years who were diagnosed with schizophrenia. Guideline adherence was assessed using the IFS and actigraphy was used to measure total sleep time (TST), sleep latency (SL), and sleep efficiency (SE). In 33 patients, these measures were re‐evaluated after 6 months.

Cross‐sectional analysis showed a positive correlation between IFS and TST (rho = 0.362, P = 0.022), which persisted after adjusting for Brief Psychiatric Rating Scale scores (β = 0.318, P = 0.024). IFS was not associated with SL or SE, and differences in hypnotic use did not significantly affect the sleep parameters. Additionally, longitudinal changes in IFS over 6 months were not significantly associated with changes in TST, SL, or SE (all P > 0.05).

In this cohort of long‐term hospitalized patients with schizophrenia, guideline adherence (higher IFS) was associated with increased TST. However, no clear longitudinal effects of IFS on sleep were observed. These findings emphasize the importance of guideline adherence in optimizing sleep, although extended follow‐ups and larger sample sizes are required to confirm the long‐term impact of guideline‐based treatments on sleep in patients with schizophrenia.

Correlation between individual fitness score (IFS) and total sleep time (TST). A significant positive correlation was observed between TST and IFS (rho = 0.362, P = 0.022).