Abstract

BackgroundA growing body of evidence points to relationships between insomnia, negative affect, and paranoid thinking. However, studies are needed to examine (i) whether negative affect mediates the relation between insomnia and paranoid thinking, (ii) whether different types of insomnia exert different effects on paranoia, and (iii) to compare the impact of objective and self-reported sleeping difficulties.MethodStructural equation modelling was therefore used to test competing models of the relationships between self-reported insomnia, negative affect, and paranoia. n = 348 participants completed measures of insomnia, negative affect and paranoia. A subset of these participants (n = 91) went on to monitor their sleep objectively (using a portable sleep monitor made by Zeo) for seven consecutive nights. Associations between objectively recorded sleep, negative affect, and paranoia were explored using linear regression.ResultsThe findings supported a fully mediated model where self-reported delayed sleep onset, but not self-reported problems with sleep maintenance or objective measures of sleep, was directly associated with negative affect that, in turn, was associated with paranoia. There was no evidence of a direct association between delayed sleep onset or sleep maintenance problems and paranoia.ConclusionsTaken together, the findings point to an association between perceived (but not objective) difficulties initially falling asleep (but not maintaining sleep) and paranoid thinking; a relationship that is fully mediated by negative affect. Future research should seek to disentangle the causal relationships between sleep, negative affect, and paranoia (e.g., by examining the effect of an intervention using prospective designs that incorporate experience sampling). Indeed, interventions might profitably target (i) perceived sleep quality, (ii) sleep onset, and / or (iii) emotion regulation as a route to reducing negative affect and, thus, paranoid thinking.

Highlights

  • Sleep problems and mental health complaints go hand-in-hand, with problems sleeping associated with many, if not all, psychiatric conditions [1,2,3,4]

  • There was no evidence of a direct association between delayed sleep onset or sleep maintenance problems and paranoia

  • The findings point to an association between perceived difficulties initially falling asleep and paranoid thinking; a relationship that is fully mediated by negative affect

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Summary

Introduction

Sleep problems and mental health complaints go hand-in-hand, with problems sleeping associated with many, if not all, psychiatric conditions [1,2,3,4]. The present research focuses on one particular sleep problem; namely, the experience of insomnia (defined as difficulties initiating and/or maintaining sleep), and its relationship with paranoid thinking. Both insomnia and paranoia are relatively common in the general population. Studies are needed to examine (i) whether negative affect mediates the relation between insomnia and paranoid thinking, (ii) whether different types of insomnia exert different effects on paranoia, and (iii) to compare the impact of objective and self-reported sleeping difficulties.

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