A Qualitative Exploration of the Barriers and Facilitators for Physical Activity Among Pregnant and Postpartum Women in Saudi Arabia.

Sleep disturbances are common amongst patients with psychotic disorders, with up to 80% found to have symptoms of sleep disorders (Reeve et al., ; Waite et al., ). The primary focus of work related to sleep disorders has been on sleep‐limiting disorders (e.g. insomnia). Disorders of extended sleep (e.g. excessive sleep/extended sleep duration) have been overlooked and ascribed to the sedating side effects of antipsychotic medications. Initial findings suggest that (1) excessive sleep significantly impacts individual functioning and emotional well‐being, (2) excessive sleep may be influenced by factors beyond medication alone – despite this, there has been a lack of comprehensive studies examining these effects in detail (Faulkner & Bee, ; Reeve et al., ). Excessive sleep is here used as an umbrella term, comprising symptoms of excessive sleepiness, extended sleep duration and hypersomnia. Excessive sleepiness can be defined as a ‘propensity to fall asleep when a conscious effort may be needed to stay awake’. Extended sleep duration refers to sleeping more than 11 h in a 24‐h period (including naps) or more than 9 h a night, based on ICSD3 and DSM5 thresholds respectively (ICSD3, American Academy of Sleep Medicine, ; DSM‐5, American Psychiatric Association, ). Hypersomnia is the combination of excessive sleepiness and extended sleep duration. Excessive sleep is relatively common in patients with psychotic disorders. A recent study revealed that 23.3% of these patients screened positive for excessive daytime sleepiness during diagnostic interviews (Reeve et al., ), and it is frequently reported by clincians (e.g. by over 70% of respondents in Rehman et al., ). Often, excessive sleepiness is accepted as a side effect of antipsychotic medications, leading to its perception as an inevitable accompaniment of such treatments (Faulkner & Bee, ). However, preliminary findings indicate that factors beyond medication might contribute to the sedation experienced by those on antipsychotics. One study found no differences in medication type or dosage between patients with and without excessive daytime sleepiness (Reeve et al., ), and another found that medication changes did not significantly reduce sleep duration (Ramos‐Perdigues et al., ). Patients experiencing excessive sleep reported higher levels of depression, anxiety and reduced quality of life, which, despite not being statistically significant, underscores the need for further investigation into the causes of these experiences (Reeve et al., ).