Targeting Sleep to Improve Outcomes in Psychosis: Digital and Non-Pharmacological Interventions

Sleep disturbances are among the most prevalent and clinically significant features observed across the psychosis spectrum, ranging from clinical high-risk (CHR) mental states to first-episode psychosis (FEP) and chronic schizophrenia. Far from being merely secondary phenomena, sleep difficulties-including insomnia, circadian rhythm disruption, altered sleep architecture, hypersomnia, and nightmare disorder-are increasingly acknowledged as transdiagnostic risk factors that may contribute to symptom severity, cognitive impairment, functional decline, and heightened suicidal risk. This narrative review consolidates current evidence on the epidemiology and neurobiological foundations of sleep disturbances in the psychosis spectrum and critically evaluates available non-pharmacological and digital interventions aimed at targeting sleep as a modifiable clinical outcome. We posit that sleep represents a critical, potentially modifiable intervention target within psychosis and that integrating sleep-focused care into standard clinical pathways may substantially enhance clinical, functional, and safety outcomes throughout the illness spectrum, pending replication in adequately powered randomized controlled trials.