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Sleep Quality as a Target for Improving Medication Adherence in Patients with Psychiatric Disorders


avatar Leeba Rezaie 1 , *

1 Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran

How to Cite: Rezaie L. Sleep Quality as a Target for Improving Medication Adherence in Patients with Psychiatric Disorders. J Kermanshah Univ Med Sci.23(1):e88889.
doi: 10.5812/jkums.88889.


Journal of Kermanshah University of Medical Sciences: 23 (1); e88889
Published Online: February 5, 2019
Article Type: Letter
Received: January 8, 2019
Accepted: January 15, 2019

Dear Editor,

Medication adherence or the extent of coinciding of personal behavior with prescribed medication (1) is an important issue in patients with psychiatric disorders. While medication adherence is associated with improvement in clinical outcome in these patients, it is reported that up to 50% of these patients do not adhere to prescribed medication, and improving adherence is considered a target for intervention (2). Several factors such as age, gender, employment, and social support impact medication adherence in psychiatric patients (3). The role of sleep in medication adherence has also been emphasized. Afonso et al. reported that patients with schizophrenia who report more sleep disturbances have more severe symptoms, and worse adherence to treatment (4). Furthermore, sleep disturbances are common in patients with psychiatric disorders.

We explored the facilitators of and barriers to medication adherence in patients with psychiatric disorders admitted to Farabi Hospital of Kermanshah University of Medical Sciences, Kermanshah, Iran (2017 - 2018). We used focus group discussions to collect patient experiences about medication adherence. Data analysis revealed that improved sleep quality was a reason for medication adherence. They stated they are motivated to continue taking the medication because medication helped them to have good sleep quality.

Comparing a previous study (4) with ours, we conclude that sleep quality impact medication adherence in patients with psychiatric disorders. While poor sleep quality is associated with poor adherence, good sleep quality can improve medication adherence. Therefore, improvement in sleep quality should be considered a primary target for treatment in these patients, and frequent assessment of sleep and emphasis on the changes in sleep quality can motivate these patients to have better medication adherence. In addition, studies to investigate the effectiveness of sleep target interventions (both medical and psychological) on long-term medication adherence can help provide evidence to support the role of sleep in this field.


  • 1.

    Dolder CR, Lacro JP, Jeste DV. Adherence to antipsychotic and nonpsychiatric medications in middle-aged and older patients with psychotic disorders. Psychosom Med. 2003;65(1):156-62. [PubMed: 12554828].

  • 2.

    Haddad PM, Brain C, Scott J. Nonadherence with antipsychotic medication in schizophrenia: Challenges and management strategies. Patient Relat Outcome Meas. 2014;5:43-62. doi: 10.2147/PROM.S42735. [PubMed: 25061342]. [PubMed Central: PMC4085309].

  • 3.

    Stentzel U, van den Berg N, Schulze LN, Schwaneberg T, Radicke F, Langosch JM, et al. Predictors of medication adherence among patients with severe psychiatric disorders: Findings from the baseline assessment of a randomized controlled trial (Tecla). BMC Psychiatry. 2018;18(1):155. doi: 10.1186/s12888-018-1737-4. [PubMed: 29843676]. [PubMed Central: PMC5975380].

  • 4.

    Afonso P, Brissos S, Canas F, Bobes J, Bernardo-Fernandez I. Treatment adherence and quality of sleep in schizophrenia outpatients. Int J Psychiatry Clin Pract. 2014;18(1):70-6. doi: 10.3109/13651501.2013.845219. [PubMed: 24047426].

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