Sleep quality, psychological symptoms, and psychotic-like experiences

Poor sleep quality has been repeatedly linked to the entire psychosis continuum, including psychotic-like experiences (PLEs); however, sleep dysfunction is a component of several other psychopathologies that have also been linked to increased risk for PLEs, including depression, anxiety, and post-traumatic stress disorder (PTSD). It has yet to be examined if PLEs are a significant risk factor for poor sleep quality or if this sleep dysfunction is better accounted for by comorbid psychopathology. In 2687 undergraduates, PLEs were evaluated using the positive items of the Prodromal Questionnaire. Symptoms of anxiety, depression, and PTSD were also assessed, as was sleep quality. Mediation analysis using PROCESS was conducted to determine if poor sleep quality associated with PLEs was in fact more associated with symptoms of other psychopathologies. Symptoms of depression and PTSD mediated the relationship between PLEs and sleep quality, though anxiety symptoms did not. These findings suggest that treating symptoms of depression and PTSD may improve multiple domains of psychotic illness.