Psychotic‐like experiences associated with sleep disturbance and brain volumes in youth: Findings from the adolescent brain cognitive development study

Abstract

Background Sleep disturbance is characteristic of schizophrenia and at‐risk populations, suggesting a possible etiological role in psychosis. Biological mechanisms underlying associations between sleep and psychosis vulnerability are unclear, although reduced sleep‐regulatory brain structure volumes are a proposed contributor. This study is the first to examine relationships between psychotic‐like experiences (PLEs; subclinical symptoms reflecting psychosis vulnerability/risk), sleep, and brain volumes in youth. Methods Brain volumes of five sleep‐related structures were examined in relation to PLEs and difficulties initiating and maintaining sleep (DIMS) in 9,260 9‐ to 11‐year‐olds participating in the Adolescent Brain Cognitive Development (ABCD) study. Analytic models examined relationships between DIMS, PLEs, and brain volumes, as well as DIMS as a mediator of brain volume–PLEs relationships. Although sleep regulation structures (i.e., thalamus, basal forebrain, and hypothalamus) were of primary interest, other potentially relevant structures to sleep‐related functioning and psychosis (i.e., hippocampus and amygdala) were also examined. Results PLEs were associated with increased DIMS as well as reduced volume in some, but not all, brain structures, including the thalamus and basal forebrain in children. DIMS was also associated with reduced left thalamus volume in youth. Increased DIMS partially, statistically mediated the relationship between left thalamic volume and PLEs, although the effect was relatively small. Conclusions Results highlight left thalamic volume as a potential neural mechanism underlying sleep disturbances and PLEs in childhood. Future studies should assess causal relationships between sleep, PLEs, and brain structure across adolescent development, interactions with other psychosis risk factors, and the role of sleep interventions in prevention of psychosis and a range of psychiatric conditions across the lifespan.

Insomnia moderates the association between psychotic-like experiences and suicidal ideation in a non-clinical population: a network analysis

“…Taken together, these observations suggest a vicious cycle conceptualization in which sleep disturbance gives rise to PLEs that might in turn contribute to increased distress further enhancing poor sleep quality [ 27 ]. Importantly, there is evidence that sleep disturbance and PLEs might share overlapping neural mechanisms represented by a reduction in volumes of the left thalamus as recently reported [ 28 ].…”

The nature, consequences, mechanisms, and management of sleep disturbances in individuals at-risk for psychosis

“…However, the nature of sleep disturbances characterizing the UHR stage remains unclear, with available studies having yielded mixed findings ( 10 ). In addition, potential mechanisms involved in the association between sleep and psychosis etiology are still largely unknown ( 17 ). We could find only one previous review that included data prior to February 2020 to examine sleep disturbances in the UHR state, with the specific goal of exploring the relationships between sleep and psychotic symptoms, functioning and quality of life ( 18 ).…”