Sleep disorders predict the one-year onset, persistence, but not remission of psychotic experiences in pre-adolescence: a longitudinal analysis of the ABCD cohort data

Abstract

Sleep problems have been reliably associated with psychotic experiences in adults and have been suggested as target for intervention. However, the relationship between sleep disorder and psychotic experiences in children has not been extensively studied despite the potential for guiding intervention. The Adolescent Brain Cognitive Development (ABCD) dataset, containing baseline and one-year follow-up data of over 11,000 10-11 year olds, was utilised to investigate this relationship. More specifically, a set of pre-registered multi-level regression models were applied to test whether a) baseline sleep disorder predicts baseline psychotic experiences cross-sectionally; b) baseline sleep disorder predicts psychotic experiences one year later; c) the persistence of sleep disorder predicts the persistence psychotic experiences at one year; d) the remission of sleep disorder predicts the remission of psychotic experiences. After controlling for potential confounders, sleep disorder was associated with psychotic experiences cross-sectionally (OR=1.40, 95% CI 1.20-1.63), at one-year follow-up (OR=1.32, 95% CI 1.11-1.57), and the persistence of sleep disorder predicted the persistence of psychotic experiences (OR=1.72, 95% CI 1.44-2.04). However, remission of sleep problems did not predict remission of psychotic experiences (OR=1.041, 95% CI 0.80-1.35). In all models where an association was found, sleep was one of the two strongest predictors of psychotic experiences (with stimulant medication being the other). The results indicate that sleep problems in children are common and strongly associated with psychotic experiences but the lack of co-remission raises questions about the mechanism of association. However given existing evidence in adults, further investigation and interest in sleep as a preventative mental health intervention in this age group is warranted.

Estimating the Association Between Exposome and Psychosis as Well as General Psychopathology: Results From the ABCD Study

“…This finding should not be surprising, given the fact that psychosis expression is on a continuum and coincides with other symptom dimensions ( 25 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ). Furthermore, psychosis expression is often preceded by a nonspecific prodrome with mixed psychopathology domains ( 42 , 43 , 44 ).…”

“…Psychosis expression is prevalent in young individuals, with around 17% of children (ages 9–12 years) from the general population reporting psychotic experiences ( 45 ). The persistence and worsening of psychosis phenotypes is related to impairment, other psychopathology, and genetic as well as environmental vulnerability ( 43 , 46 , 47 , 48 , 49 , 50 ). Early psychosis expression may signal an early stage of psychopathology in young individuals, accompanied by a heterogeneous and nonspecific manifestation of clinical symptoms ( 35 , 44 , 45 , 51 , 52 , 53 ).…”

Explaining the Association Between Urbanicity and Psychotic-Like Experiences in Pre-Adolescence: The Indirect Effect of Urban Exposures

“…Analyses with the distress score are provided in the supplement. Following the analytical approach of others examining changes in PLE in the ABCD dataset (58), we created dichotomous outcome variables representing (a) the persistence of PLE from baseline to one-year follow-up and (b) the onset of new PLE at one-year follow-up. These variables were created by first evaluating the presence of any PLE at baseline (0 = no, 1 = yes) and follow-up (0 = no, 1 = yes).…”