Abstract
AIM: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.