Evidence map›Paper›PMID 39929600›Full record

SynthesisBMJ mental health2025

Digital sleep phenotype and wrist actigraphy in individuals at clinical high risk for psychosis and people with schizophrenia spectrum disorders: a systematic review and meta-analysis.

Rosario Aronica, Edoardo Giuseppe Ostinelli, Charlotte Austin, Dominic Oliver, Philip McGuire, Paolo Brambilla, John Torous, Andrea Cipriani

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMJ mental health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Circadian rhythms and mental health.BMJ mental health · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Rosario AronicaDepartment of Pathophysiology and Transplantation, University of Milan, Milano, Italy r.aronica.med@gmail.com.ORCID 0000-0002-7994-3938
Edoardo Giuseppe OstinelliDepartment of Psychiatry, University of Oxford, Oxford Precision Psychiatry Lab (OxPPL), Oxford, UK.ORCID 0000-0002-8717-0832
Charlotte AustinDepartment of Psychiatry, University of Oxford, Oxford, England, UK.
Dominic OliverDepartment of Psychiatry, University of Oxford, Oxford, England, UK.
Philip McGuireDepartment of Psychiatry, University of Oxford, Oxford, England, UK.
Paolo BrambillaDepartment of Pathophysiology and Transplantation, University of Milan, Milano, Italy.
John TorousPsychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.ORCID 0000-0002-5362-7937
Andrea CiprianiDepartment of Psychiatry, University of Oxford, Oxford Precision Psychiatry Lab (OxPPL), Oxford, UK.ORCID 0000-0001-5179-8321

Funding

UK NIHR Oxford Biomedical Research Centre NIHR-203316Wellcome Trust
6 · The paper itself

Abstract

aimTo identify sleep abnormalities in individuals at clinical high risk for psychosis (CHR-P) or with schizophrenia spectrum disorders (SSDs) compared with healthy controls (HCs) using wrist actigraphy, and to assess potential differences in the direction of effect with self-reported assessments of sleep.

methodsWe conducted a systematic review of observational studies, with the search last updated on 29 April 2024. Primary outcome was total sleep time (TST), with secondary outcomes including time in bed (TIB), sleep latency, sleep efficiency, wake after sleep onset, nighttime awakenings and self-reported sleep quality. Random-effects pairwise meta-analyses were used to summarise the effects of each outcome.

resultsNineteen studies were included, with 18 contributing to the meta-analyses (202 CHR-P, 584 SSD, 582 HC). TST results were inconclusive for CHR-P (MD -4.88 min (95% CI -20.57 to 10.81)), while SSD participants showed an increase in TST compared with HC (MD 106.13 min (86.02 to 124.24)). Factors such as antipsychotic medications (pseudo-R²=88.14%), age (38.89%) and gender (26.29%) partially explained the heterogeneity between subgroups. Additionally, CHR-P individuals exhibited reduced sleep efficiency (MD -2.04% (-3.55 to 0.53)), whereas SSD participants had increased TIB (MD 121.58 min (88.16 to 155.00)) and sleep latency (MD 13.05 min (2.11 to 24.00)). The risk-of-bias assessment ranged from

conclusionsOur analyses identified sleep abnormalities in CHR-P and SSD compared with placebo. However, observed heterogeneity and potential biases across studies may limit the interpretability of findings. These limitations underscore the need for standardised guidelines and more precise participant stratification.

Indexed as

ActigraphyPsychotic DisordersSchizophreniaSleepSleep Wake DisordersHumansPhenotypeAdult psychiatryData Interpretation, StatisticalSchizophrenia & psychotic disordersSleep

Identifiers

PMID39929600
PMCPMC11815447

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.