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Updated: Jul 10, 2026

Association Between Sleep Quality and Cognitive Symptoms in Patients with Major Depressive Disorder
Published on: April 26, 2024
Self reported sleep quality and cognitive performance in ecstasy users
Catharine Montgomery1, John E Fisk, Michelle Wareing
1Liverpool John Moores University, Liverpool, UK. c.a.montgomery@ljmu.ac.uk
Objectives:
Research suggests that ecstasy users exhibit psychobiological changes relative to nonusers such as altered sleep patterns and cognitive deficits. In turn, it has been suggested that sleep quality may be a mediator of such cognitive deficits in ecstasy users. The present study sought to investigate this proposed relationship.
Methods:
Aspects of cognitive functioning in 104 ecstasy users and 103 nonusers obtained from our previous studies were reanalysed to explore the extent to which ecstasy-related group differences were attributable to differences in sleep quality. Cognitive function was assessed via the computation span test, consonant updating, paired associate learning, syllogistic reasoning and word fluency. Sleep quality was measured via the Epworth Sleepiness Scale (ESS), and the Karolinska Sleepiness Scale (KSS).
Results:
Ecstasy users performed worse than nonusers on all cognitive measures. While no differences were observed on the ESS, ecstasy users reported greater tiredness at the beginning of testing than nonusers. When the sleep variables were included as covariates, the effects of ecstasy on all cognitive measures remained significant.
Conclusions:
The results of the present study suggest little evidence for the mediating effects of sleep on cognitive function in ecstasy users.
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