Lack of sleep in childhood increases risk of psychosis in early adulthood

Key takeaways:

• Children with shorter sleep durations were more than twice as likely to develop psychosis disorder in early adulthood.
• Elevated interleukin-6 levels partially mediated the association.

Persistent shorter sleep durations during childhood were associated with a greater risk of psychosis disorder and psychotic episodes during early adulthood, a study in JAMA Psychiatry showed.

“It’s entirely normal for children to suffer from sleep problems at different points in their childhood, but it’s also important to know when it might be time to seek help,” Isabel Morales-Muñoz, PhD, an assistant professor in psychology at the University of Birmingham in the United Kingdom, said in a press release. “Sometimes sleep can become a persistent and chronic problem, and this is where we see links with psychiatric illness in adulthood.”

According to Morales-Muñoz and colleagues, prior studies in this area have only assessed the short-term impact of sleep on psychosis.

For the current study, Morales-Muñoz and colleagues assessed data on 12,394 children (50.5% girls) and 3,962 young adults (61.3% women) who were enrolled in the Avon Longitudinal Study of Parents and Children.

Nighttime sleep duration data were collected at several points between ages 6 months to 7 years, while psychosis disorder and psychotic episodes were assessed at age 24 years.

The researchers also investigated whether inflammation could account for the link between shorter sleep and psychosis, as previous research indicated it may have a role. To do this, they measured levels of interleukin-6 and C-reactive protein in blood samples.

Overall, children with persistent shorter sleep durations were more than twice as likely to develop psychosis disorder (OR = 2.5; 95% CI,1.51-4.15) and were nearly four times as likely to experience psychotic episodes at age 24 years (OR = 3.64; 95% CI,2.23-5.95).

Morales-Muñoz and colleagues reported that higher levels of interleukin-6 at age 9 years partially mediated the associations.

“Although significant, the size of the association and the proportion of the association mediated was low, which indicates that other factors are also potentially explaining these associations,” the researchers wrote. “Future studies should further explore the specific role of inflammation as a potential mediating factor in the prospective associations between sleep and psychosis, together with other potentially relevant mediating factors.”

There were multiple limitations of the study. For example, it only focused on parent- or self-reported sleep, “which could be different from objective sleep,” the researchers explained. Additionally, generalizability was limited due to most of the participants being white individuals.

“The good news is that we know that it is possible to improve our sleep patterns and behaviors,” Morales-Muñoz said. “While persistent lack of sleep may not be the only cause of psychosis in early adulthood, our research suggests that it is a contributing factor, and it is something that parents can address.”

References:

• Children sleep problems associated with psychosis in young adults. https://www.birmingham.ac.uk/news/2024/children-sleep-problems-associated-with-psychosis-in-young-adults. Published May 8, 2024. Accessed May 14, 2024.
• Morales-Muñoz I, et al. JAMA Psychiatry. 2024;doi:10.1001/jamapsychiatry.2024.0796.