European child & adolescent psychiatryMay 27, 2025

How changes in sleep problems relate to psychotic-like experiences in teens, with depression symptoms as a link

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗

Updated Apr 4, 2026

Abstract

A total of 7,529 adolescents participated in the study evaluating sleep disturbance and psychotic-like experiences.

Five distinct patterns of sleep disturbance were found: no/low (72.2%), remission (8.8%), relapsing/remitting (7.4%), new-onset (8.9%), and persistent (2.7%).
Depressive symptoms were shown to partially mediate the relationship between certain sleep disturbance patterns and psychotic-like experiences.
The mediation effects were significant for relapsing/remitting, new-onset, and persistent sleep disturbances.
The confidence intervals for the mediation effects were reported as 0.20-0.30, 0.42-0.53, and 0.41-0.58, respectively.
Early screening and interventions focusing on sleep disturbance and depressive symptoms may be important to help prevent the onset of psychotic-like experiences.

Simplified

Previous work supported the opinion that sleep disturbance may cause adolescent PLEs. This study intended to evaluate the mediating effect of depressive symptoms on the relationship between change in sleep disturbance and psychotic-like experiences (PLEs) among adolescents. A total of 7529 adolescents completed three web-based surveys. Surveys were administered from April 21 to May 12, 2021 (Time 1, T1), again 6 months later from December 17 to 26, 2021 (Time 2, T2), and one year later from May 17 to June 5, 2022 (Time 3, T3). A series of self-assessment scales were used to measure sleep disturbance, depressive symptoms, PLEs, and other relevant variables. Mediation analysis was utilized to examine the association between sleep disturbance trajectories, depressive symptoms, and PLEs. Five trajectories of sleep disturbance were identified: no/low (72.2%), remission (8.8%), relapsing/remitting (7.4%), new-onset (8.9%), and persistent (2.7%) trajectories. Depressive symptoms partially mediated the effects of sleep disturbance trajectories (relative to the no/low trajectory) on PLEs (95% CIs: 0.20-0.30, 0.42-0.53, and 0.41-0.58 for relapsing/remitting, new-onset, and persistent trajectories, respectively). This study reveals that the association between sleep disturbance trajectories and PLEs was partially mediated by depressive symptoms. To prevent the onset of PLEs, early screening and interventions targeting sleep disturbance and depressive symptoms are quite essential.

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Declarations. Ethics approval and consent to participate: This study was approved by the Human Research Ethics Committee of South China Normal University. The survey was under the principle of voluntary participation. The participants and their guardians carefully read, signed and returned the informed consent form to the researcher. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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How changes in sleep problems relate to psychotic-like experiences in teens, with depression symptoms as a link

Abstract

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Competing interests

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