ABSTRACT Background Compared to the general population, people with experience of psychosis have poorer physical fitness, higher levels of sedation, lower levels of physical activity, more sleep problems, and higher incidence of insomnia. Methods Thirty-one early intervention psychosis (EIP) service patients took part in an eight-week intervention: provision of a Fitbit, Fitbit software apps, sleep and physical activity guidance, and three discussion sessions with clinicians. Fifteen participants consented to be interviewed, 9 males and 6 females, age range 19–51, average age 29. In-depth interviews investigating patient experiences of sleep and physical activity were conducted. Thematic analysis was employed. Results Patients using an EIP service experience particular issues, problems, and barriers to engaging in effective and healthy sleep and physical activity/exercise; these can have a negative effect on mental and physical health, wellbeing, recovery, and sociability. Patients used factors such as medication, social support, practical strategies, and motivation enhancement to overcome issues, problems, and barriers. Discussion Healthy effective sleep and physical activity/exercise is important to EIP service patients’ wellbeing and mental and physical health. EIP services should consider and assess sleep and physical activity/exercise issues, and promote healthy effective sleep and physical activity/exercise within recovery focused practice.