Poor sleep quality predicts psychotic-like symptoms: an experience sampling study in young adults with schizotypal traits.

Abstract

Psychotic-like experiences (PLEs) are unusual experiences such as perceptual abnormalities and delusional-like thoughts that resemble the symptoms of psychosis at the sub-clinical level. PLEs are associated with sleep complaints in healthy and clinical samples; however, evidence for day-to-day associations between poor sleep and subsequent PLEs under naturalistic conditions is scarce. We hypothesized that poor sleep quality would predict next days' PLEs, and vice versa, daytime PLEs would be associated with worse subsequent sleep quality. Seventy-three university students with moderate to high levels of positive schizotypy participated in an experience sampling study. Participants rated their sleep each morning, as well as PLEs and affective states during the day over 3weeks. Multilevel regression models indicated that poor sleep quality predicted increased PLEs the following day. Poor sleep was linked to negative daytime mood that partially mediated the associations between sleep quality and next days' PLEs. Furthermore, PLEs were enhanced in the evening as compared to daytime reports. The prediction of poor sleep quality by previous days' PLEs was negligible. The results are consistent with the position that sleep-related interventions might reduce the risk of psychosis, especially in individuals that tend to experience psychotic-like phenomena and negative affect.