# The Temporal Dynamics of Sleep Disturbance and Psychopathology in Psychosis: A Digital Sampling Study https://pubmed.ncbi.nlm.nih.gov/33431090/ Nicholas Meyera,b,∗, Dan W Joycec, Chris Karrd, Maarten de Vose,f, Derk-Jan Dijkg,h, Nicholas C Jacobsoni, James H MacCabea,b [[Meyer, et al., 2020.pdf]] [[DP - Sleep]] [[psychopathology]] [[Schizophrenia]] Related to [[On Prodrome and Relapse]] ---- Results: Poorer sleep quality and shorter sleep duration maximally predicted deterioration in psychosis symptoms over the subsequent 1-8 and 1-12 days, respectively. These relationships were also mediated by negative affect and cognitive symptoms. Psychopathology variables also predicted sleep quality, but not sleep duration, and the effect sizes were smaller and of shorter lag duration. > [!info] > Poorer sleep quality and duration also anticipate worsening in negative affect and coginitive symptoms, from between one to 15 days before the deterioration in mood and cognition. Similarly, better sleep quality (but not sleep duration) predicted greater positive affect, but with a shorter lag duration of up to 5 days. Sleep disruption is a common precursor to deterioration and relapse in people living with psychotic disorders. Understanding the temporal relationship between sleep and psychopathology is impor- tant for identifying and developing interventions which target key variables that contribute to relapse **Poorer sleep predict next day negative affect and psychosis symptoms** - Mulligan et al. (2016) found that poorer sleep predicted greater next-day negative affect and psychosis symptoms, with negative affect mediating a proportion of this relationship. - in a 6-day ESM study in individuals on the psychosis-spectrum, Kasanova et al. (2020) reported a significant effect of poor sleep quality on paranoia the next morning, with negative affect fully mediating the relationship. - Reeve et al. (2018) assessed subjective insomnia, psychosis and negative affect symptoms at monthly intervals over three months, in 29 patients with non-affective psychosis. Insomnia predicted later psychosis symptoms, and this relationship was again mediated by negative affect. T==his study also found a reciprocal effect between psychotic symptoms and insomnia, implying a bidirectional relationship between these variables.==