Examining the relationship between sleep disturbance and ICD-11 personality disorder in a community sample

There is a substantial literature on the associations between personality disorder (PD) and sleep dysfunction, but the majority of studies have focused on borderline PD. Studies that have taken a broader perspective have indicated that associations between PD and sleep problems are diffuse. The current study examined associations between the International Classification of Diseases, 11th revision (ICD-11) PD (severity and traits) with a diverse set of sleep problems as well as the role of adverse childhood experiences (ACEs) and executive functioning in explaining the overlap between PD and sleep dysfunction. Participants were 503 individuals with mental health histories recruited via Prolific Academic from six English-speaking countries and completed a battery of self-report questionnaires targeting the constructs of interest. The results show that ICD-11 PD severity and negative affectivity were both distinctly associated with insomnia severity and presleep arousal. To a lesser degree, disinhibition was primarily associated with an eveningness chronotype and daytime sleepiness. Although both ACEs and executive dysfunction explained the overlap of the PD constructs with insomnia severity and presleep arousal, the latter was associated with a much larger effect size. The findings indicate that a dimensional PD model such as the one included in ICD-11 can be useful in elucidating how PD is related to sleep problems, and this overlap should also signal to clinicians to assess for and intervene with sleep problems in clients with PDs. (PsycInfo Database Record (c) 2026 APA, all rights reserved).