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Childhood parasomnias increase risk for psychotic experiences in early adulthood

Persistent childhood nightmares and night terrors were associated with increased risk for psychotic experiences at age 18 years, according to study findings in The British Journal of Psychiatry.

“Although recent research has suggested that the relationship between established risk factors for schizophrenia and psychotic experiences may be weaker than initially thought, the relevance of these subclinical experiences to early intervention strategies in psychosis remains important,” study researcher Andrew Thompson, MD, FRCPsych, of the University of Warwick, Coventry, United Kingdom, and colleagues wrote. “One such potential risk factor in children that can be readily identified by parents, children and professionals is disturbance of sleep.”

To examine sleep disturbances in relation to psychotic experiences, researchers assessed data for 4,720 individuals from a birth cohort study conducted in the United Kingdom. From ages 2 to 9 years, mothers reported children’s experiences of regular nightmares. At age 12 years, nightmares, night terrors and sleepwalking were assessed. Psychotic experiences were evaluated at age 12 and 18 years.

In unadjusted analysis, children who experienced nightmares at age 12 years had an overall risk of 2.14 (95% CI, 1.59—2.87) for psychotic experiences at age 18 years. Those who experienced night terrors at age 12 years had an overall risk of 1.93 (95% CI, 1.28-2.91). Experiencing any parasomnias (nightmares, night terrors or sleepwalking) at age 12 years was associated with an overall risk of 2.00 (95% CI, 1.5-2.66) for psychotic experiences at age 18 years.

When adjusting for gender, Family Adversity Index score, enuresis, IQ at age 8 years, depression score at ages 10 through 12 years, sexual or physical abuse, Development and Well-Being Assessment score, anxiety disorder and psychotic experiences at age 12 years attributed to sleep and fever, overall risk for psychotic experiences was lower but remained significant for nightmares (OR = 1.62; 95% CI, 1.19-2.2) and any parasomnias (OR = 1.6; 95% CI, 1.19-2.16) at age 12 years.

Sleepwalking at age 12 years was not significantly associated with psychotic experiences at age 18 years in unadjusted and adjusted analyses.

“The clinical relevance of these findings may relate to the way that early nightmares (especially) and night terrors are viewed and potentially addressed by professionals or carers,” Thompson and colleagues wrote. “It is likely that in some individuals, nightmares and night terrors have little significance to late psychopathology, however in individuals with additional risks such as family psychiatric history or a past trauma exposure by adults or peers, such sleep problems may have greater significance and may also highlight other unnoticed psychopathology or trauma.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.