{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:26:09Z","timestamp":1788337569453,"version":"build-2803163510"},"reference-count":154,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>Sleep architecture alterations have been shown in major psychiatric disorders, but the contribution of demographic factors to between-study heterogeneity remains insufficiently characterized. This study reports a transdiagnostic systematic review and meta-regression of case-control polysomnographic studies comparing schizophrenia, bipolar disorder, and unipolar depression with healthy controls. The factors age and sex as possible moderators across harmonized case-control polysomnographic studies have been analyzed. Eligible studies reported diagnostic criteria, treatment status, age, and sex. Because the UD literature encompassed developmentally distinct populations, pediatric\/adolescent and adult studies were analyzed separately. Standardized mean differences were synthesized using random-effects models with REML estimation. Univariable mixed-effects meta-regressions assessed study-level mean age and sex composition as moderators within each diagnostic group. Study-level mean age and sex composition significantly moderated delta sleep effect sizes in drug-naive schizophrenia, while study-level mean age significantly moderated REM time in drug-free schizophrenia. In bipolar disorder, study-level mean age moderated REM sleep time effect sizes during mania, whereas sex composition moderated delta sleep and REM density effect sizes. In UD, study-level mean age moderated total sleep time, and sex composition moderated wake after sleep onset only in pediatric\/adolescent studies, whereas no significant moderation was observed in adult samples. No significant moderator effects were identified during bipolar depression. Overall, demographic composition explained only a modest proportion of between-study heterogeneity. Interpretation is limited by the ecological nature of study-level meta-regression and residual study heterogeneity.<\/jats:p>","DOI":"10.3390\/biology15171487","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T07:53:11Z","timestamp":1788335591000},"page":"1487","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Age and Sex as Moderators of Sleep Architecture in Schizophrenia, Bipolar Disorder, and Unipolar Depression: A Case-Control Polysomnographic Systematic Review and Meta-Regression"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0997-9124","authenticated-orcid":false,"given":"Dario","family":"Morra","sequence":"first","affiliation":[{"name":"Department of Psychology, Universit\u00e0 degli Studi della Campania \u201cLuigi Vanvitelli\u201d, Viale Ellittico 31, 81100 Caserta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6523-5327","authenticated-orcid":false,"given":"Giuseppe","family":"Barbato","sequence":"additional","affiliation":[{"name":"Department of Psychology, Universit\u00e0 degli Studi della Campania \u201cLuigi Vanvitelli\u201d, Viale Ellittico 31, 81100 Caserta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.jsmc.2022.03.002","article-title":"Sleep-Wake Neurochemistry","volume":"17","author":"Holst","year":"2022","journal-title":"Sleep Med. 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