Understanding the Link Between Sleep Disturbance and Psychosis Proneness

Courtney Spitzer, BA

Beth Israel Deaconess Medical Center – Research Assistant
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Scientific Abstract


There is a strong relationship between sleep disturbance and psychosis proneness. Still, our understanding of the nature of this relationship remains limited.  In this study, we aim to shed light on the mechanism by which sleep disruption may precipitate psychotic illness by investigating mediating variables.


To replicate the relationship between sleep disturbances and psychosis proneness, we investigated a sample of non-help seeking, healthy controls (HC; N=247).  To assess for psychosis proneness and sleep quality, these subjects completed the Wisconsin Schizotypy Scales (a shortened version of the Chapman Psychosis Proneness Scales) and the Pittsburg Sleep Quality Index (PSQI).  Pearsons’s r was then used to evaluate bivariate correlates.

Next, a combined sample consisting of subjects with a diagnosed psychotic disorder (EC; n=24) and high genetic risk of developing a psychotic disorder (FHR; n=27), completed the Chapman Psychosis Proneness Scales and PSQI.  They were rated on severity of negative affect and somatic concern using the Positive and Negative Syndrome Scale.  Attention was measured using the MATRICS Consensus Cognitive Battery.  Pearsons’s r was used to evaluate bivariate correlates.  Causal mediation analyses were performed to measure the mediating effect of negative affect, somatic concern, and attention in the relationship between sleep quality and psychosis proneness.


We identified a significant positive relationship between psychosis proneness and sleep quality in our HC sample (r = .23, p < .001), and combined EC/FHR sample (r = .45, p=.0066).

We found no evidence of a mediating effect of attention on this relationship.  We found significant indirect effects of negative affect and somatic concern (p<0.05), with negative mood and somatic concern mediating 42.6% and 38.5% of the relationship, respectively.


Poorer sleep quality correlates significantly to increased psychosis proneness in clinical and nonclinical samples.  Negative affect and somatic concern significantly mediate this relationship, suggesting that when treating psychotic illness, both sleep quality and negative affect should be targeted.


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research Areas


Courtney Spitzer, BA, Nandita Banik, BA, Bailey Driscoll, BA, Nick Raymond, BA, Christine Talbot, BA, Robert Stickgold, PhD, Dara Manoach, PhD Matcheri Keshavan, MD, Bengi Baran, PhD

Principal Investigator

Matcheri Keshavan, MD