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Associations between Sleep Problems, Psychotic Experiences and Mental Disorders in Children at Familial High Risk of

Anne Søndergaard1, Nicoline Hemager2, Martin Wilms3

  • 1CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Denmark.

Schizophrenia Research
|March 3, 2026
PubMed

Insights

Children experiencing nightmares, prolonged sleep latency, and nocturnal awakenings show associations with psychotic experiences and mental disorders. These sleep problems may serve as early indicators for mental health concerns in youth.

Area of Science:

  • Child and Adolescent Psychiatry
  • Sleep Medicine
  • Developmental Psychology

Background:

  • Sleep disturbances are recognized precursors to schizophrenia and bipolar disorder.
  • Childhood psychotic experiences and mental disorders are established risk factors for adult-onset schizophrenia and bipolar disorder.
  • Familial high-risk (FHR) studies are crucial for understanding early markers of severe mental illness.

Purpose of the Study:

  • To investigate the association between specific sleep problems (nightmares, prolonged sleep latency, nocturnal awakenings) and psychotic experiences.
  • To examine the link between these sleep problems and diagnosed mental disorders in children.
  • To compare these associations in children with familial high risk for schizophrenia (FHR-SZ), familial high risk for bipolar disorder (FHR-BP), and population-based controls.

Main Methods:

  • A cohort of 447 children aged 11-12 years was studied, comprising 170 FHR-SZ, 103 FHR-BP, and 174 controls.
  • Parental reports were collected on children's nightmares, sleep latency, and nocturnal awakenings.
  • Psychotic experiences and mental disorders were assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS).

Main Results:

  • Children with psychotic experiences exhibited higher odds of nightmares, prolonged sleep latency, and nocturnal awakenings.
  • The association between psychotic experiences and nocturnal awakenings remained significant after controlling for mental disorders.
  • Children with mental disorders showed significantly higher odds for all assessed sleep problems (nightmares, prolonged sleep latency, nocturnal awakenings).
  • Associations between sleep problems and mental health indicators were consistent across familial risk groups.

Conclusions:

  • Nightmares, prolonged sleep latency, and nocturnal awakenings are linked to psychotic experiences and mental disorders in children, irrespective of familial risk status.
  • Routine assessment of sleep problems in child and adolescent mental health services is recommended.
  • Identifying these sleep disturbances may offer valuable clinical insights as potential early markers for mental health risks.
Abstract

Keywords:
Bipolar disorderChildren at familial high riskMental disordersPsychotic experiencesSchizophreniaSleep

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