Abstract
OBJECTIVE: To investigate the associations of sleep behaviors with the risk of schizophrenia, and explore the interplay between genetic and sleep patterns in the development of schizophrenia.
METHODS: We included participants who were free of schizophrenia at baseline based on the UK Biobank. Cox proportional hazard regression models were used to evaluate the associations of five sleep behaviors and sleep pattern with the risk of schizophrenia. The schizophrenia polygenic risk score (PRS) was categorized into high, intermediate, and low-risk groups using PRS tertiles. We finally explored the interactions of sleep patterns and genetic susceptibility on both multiplicative and additive scales.
RESULTS: During the 13.74 years follow-up, 231 individuals developed schizophrenia. We found that long sleep duration, an eveningless chronotype, napping during the day, difficulty getting up in the morning were independently associated with an increased risk of schizophrenia. Comparing those with healthy sleep pattern to those with unhealthy sleep pattern participants, the HR of developing schizophrenia was 1.75(95 % CI, 1.15-2.64). Similarly, individuals with a high PRS had a risk of 3.68 (95 % CI, 2.47-5.49) compared to those with a low PRS. Notably, individuals with both high PRS and unhealthy sleep pattern had a significantly higher risk of schizophrenia(HR = 5.80, 95 % CI, 2.55-13.20) compared to those with a low PRS and a healthy sleep pattern. Additionally, the coexistence of medium PRS and intermediate healthy sleep pattern has an additive interaction on the risk of developing schizophrenia.
CONCLUSIONS: Our findings suggest that a healthy sleep pattern and low genetic risk were associated with a reduced risk of developing schizophrenia.