The effect of sleep disturbance trajectories on psychotic-like experiences among adolescents: the mediating role of depressive symptoms.

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.