Relationship between Sleep and Socio-Occupational Functioning in Early Psychosis: A Systematic Review
Year: 2025
Type: preprint
Study design: Systematic Review
Abstract: Aim: Sleep problems and impaired socio-occupational functioning (SOF) are highly prevalent in early psychosis. Although research in this area is growing, the relationship between these domains remains unclear. This systematic review synthesises evidence on the association between sleep disturbance and SOF in at-risk mental states and first-episode psychosis, focusing on two questions: (1) what is the relationship between sleep disturbance and SOF in early psychosis, and (2) do psychological sleep interventions improve SOF in this population? Methods: A comprehensive search across PsycINFO, CINAHL, MEDLINE, EMBASE and Scopus databases was conducted in February 2025. Eligible studies reported on the association between sleep and SOF in early psychosis populations. Additionally, intervention studies targeting sleep were included if they met the above criteria. Study characteristics and findings were extracted for synthesis and analysis. Results: Out of 8,682 studies, 13 met the inclusion criteria. Most studies reported that poorer sleep (e.g. insomnia, reduced quality, circadian disruption) was associated with lower SOF across commonly used measures (e.g. GAF, WSAS, SOFAS). Intervention studies, primarily CBT-based, showed improvements in sleep with indications of benefit for SOF, though mediation analyses were limited. Heterogeneity in design, sample size and measures precluded meta-analysis. Conclusions: Sleep disturbance is consistently linked with poorer socio-occupational functioning in early psychosis, and sleep-focused psychological interventions show promise for functional improvement. Routine assessment and treatment of sleep problems should be considered within early intervention pathways. Robust trials with larger, diverse samples and standardised sleep and functioning measures are recommended. Keywords: at-risk mental state, first episode psychosis, sleep disturbance, socio-occupational functioning
Authors: Sara Schjølberg Marques, Richard Meiser-Stedman, Sheri Oduola
Institution: University of East Anglia
Language: English
Topic: Sleep and related disorders
Subfield: Experimental and Cognitive Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Award: G2002843587
OpenAlex ID: W4414622201
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