Lack of sleep during childhood linked to increased risk of psychosis

Summary: Children who experience consistent sleep deprivation from infancy to toddlerhood are much more likely to develop psychosis as young adults. By analyzing data from the Avon Longitudinal Study of Parents and Children, researchers found that chronic sleep deprivation is a strong predictor of psychotic disorders and psychotic episodes later in life.

This study, the first of its kind to link persistent sleep problems to future mental health problems, highlights the importance of treating sleep problems as early as possible. Research has also explored potential biological explanations, such as immune system deficiencies, indicating complex interactions between sleep, physical health and mental health.

Highlights:

1. Strong link with psychosis: Children who had persistently reduced sleep were more than twice as likely to develop psychotic disorders and nearly four times as likely to experience psychotic episodes in early adulthood.
2. Long-term study data: The findings are based on the comprehensive Avon Longitudinal Study of Parents and Children, which tracks sleep habits from 6 months to 7 years and mental health at age 24.
3. Potential biological links: Preliminary findings suggest that immune system dysfunction, marked by high levels of inflammation, may partly explain the relationship between sleep deprivation and psychosis, although other factors are likely involved.

Source: University of Birmingham

Children who suffer from chronic lack of sleep starting in childhood may be at increased risk of developing psychosis in early adulthood, new research suggests.

Researchers at the University of Birmingham examined information on nighttime sleep duration from a large cohort study of children aged 6 months to 7 years.

They found that children who consistently slept fewer hours during this period were more than twice as likely to develop a psychotic disorder in early adulthood and nearly four times as likely to have a psychotic episode .

While previous research has found links between sleep problems and psychosis at specific time points, this study is the first to show that persistent lack of sleep is a strong predictor of psychosis.

Lead author Dr Isabel Morales-Muñoz said: “It’s completely normal for children to experience sleep problems at different times in their childhood, but it’s also important to know when it’s time to ask help. Sometimes sleep can become a persistent and chronic problem, and this is where we see links to psychiatric illnesses in adulthood.

“The good news is that we know it is possible to improve our sleep habits and behaviors. Although 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 something parents can address.

The results, published in JAMA Psychiatrywere based on data from the Avon Longitudinal Study of Parents and Children (ALSPAC), which includes records from 12,394 children aged 6 months to 7 years and 3,889 to 24 years.

Although the association between lack of sleep in childhood and psychosis in early adulthood was robust in the study, the team did not prove causality and other associated factors sleep and psychosis in children must be explored.

The team looked, for example, at overall immune system health in children to see whether immune system deficiencies could also explain some of the associations between sleep deprivation and psychosis.

This was tested at age nine by measuring levels of inflammation in blood samples. The results showed that a weakened immune system could partly explain the links between lack of sleep and psychosis, but other unknown factors could also play an important role.

Dr Morales-Muñoz’s research is part of the Mental Health Mission Midlands Translational Centre, led by the University of Birmingham and funded by the National Institute for Health and Care Research. Its objective is to test and validate treatments against early psychosis and depression in children and young people.

“We know that early intervention is very important in helping young people with mental illness. One of the priorities of the Midlands Mental Health Mission’s Center for Translational Research Excellence is to develop and test targeted interventions that could have a real impact on young people living with or at risk of developing one.

“Understanding the role that good sleep hygiene plays in positive mental health could be a very important part of this process.”

About this news on research on sleep, psychosis and neurodevelopment

Author: Beck Lockwood
Source: University of Birmingham
Contact: Beck Lockwood – University of Birmingham
Picture: Image is credited to Neuroscience News

Original research: Free access.
“Short sleep duration in childhood and psychosis in young adults: the role of inflammation” by Isabel Morales-Muñoz et al. JAMA Psychiatry

Abstract

Short sleep duration in childhood and psychosis in young adults: the role of inflammation

Importance

Short sleep duration over a prolonged period during childhood could have a detrimental impact on long-term mental health, including the development of psychosis. Furthermore, the potential underlying mechanisms of these associations remain unknown.

Objective

To examine the association between persistent shorter nighttime sleep duration throughout childhood with psychotic experiences (PE) and/or psychotic disorders (PD) at age 24 and whether inflammatory markers ( C-reactive protein (CRP) and interleukin 6 (IL-6)) potentially mediate any association.

Design, setting and participants

This cohort study used data from the Avon Longitudinal Study of Parents and Children. Data analysis was carried out from January 30 to August 1, 2023.

Exhibitions

Nighttime sleep duration was collected at 6, 18, and 30 months and at 3.5, 4 to 5, 5 to 6, and 6 to 7 years.

Main results and measures

PE and PD were assessed at age 24 from the psychosis-like symptom interview. CRP level at 9 and 15 years and IL-6 level at 9 years were used as mediators. Latent class growth analyzes (LCGA) were applied to detect nighttime sleep duration trajectories, and logistic regressions were applied for longitudinal associations between nighttime sleep duration trajectories and psychotic outcomes at age 24 years. Path analyzes were applied to test CRP and IL-6 as potential mediators.

Results

Data were available on 12,394 children (6,254 girls (50.5%)) for LCGA and on 3,962 young adults (2,429 girls (61.3%)) for logistic regression and path analyses. The LCGA identified a group of individuals with persistently shorter nighttime sleep duration throughout childhood. These individuals were more likely to develop PD (odds ratio (OR), 2.50; 95% CI, 1.51-4.15; P.< 0.001) and PE (OR, 3.64; 95% CI, 2.23-5.95; P.< 0.001) at 24 years old.

Increased levels of IL-6 at age 9, but not CRP at age 9 or 15, partially mediated the associations between shorter and persistent sleep duration and PD (bias-corrected estimate = 0.003; 95 CI %, 0.002-0.005; P.= 0.007) and PE (bias-corrected estimate = 0.002; 95% CI, 0-0.003; P.= 0.03) in young adults.

Conclusions and relevance

The results of this cohort study highlight the need to address short sleep duration in children, as persistence of this sleep problem was associated with later psychosis. This study also provides preliminary evidence for future targeted interventions in children addressing both sleep and inflammatory responses.