Aug 2026· Behaviour Research and Therapy· Vol 205, pp.
105143
· 0 citations· 36 references
Medicine
TL;DR
Cumulative SQ, indexed by a three-night pile-up measure, consistently outperformed raw SQ and alternative indices in predicting higher PA and lower NA at both within- and between-person levels, and highlights cumulative sleep quality as a clinically relevant marker of short-term affective vulnerability.
Abstract
Sleep disturbances are a transdiagnostic risk factor for affective dysregulation, which is assumed to mediate the association with suicide-related thoughts and behaviors (STBs). Yet most ecological momentary assessment (EMA) studies rely on single-night sleep metrics. With the aim of examining the link between sleep and affect, this study compared the predictive utility of multiple EMA-derived sleep indices with raw sleep measures in a sample at high risk of STBs. Following discharge, psychiatric inpatients with recent suicidal crises (N = 136) completed EMAs of sleep quality (SQ), total sleep time (TST), and affect. Multilevel models examined whether cumulative or variability-sensitive sleep indices better predicted next-day positive and negative affect (PA, NA) and affective instability compared to raw scores. Cumulative SQ, indexed by a three-night pile-up measure, consistently outperformed raw SQ and alternative indices in predicting higher PA and lower NA at both within- and between-person levels. In contrast, TST indices showed no robust associations with affect. These findings highlight cumulative sleep quality as a clinically relevant marker of short-term affective vulnerability. Future studies should explore whether this translates into increased STB risk to explore potential implications for risk monitoring and just-in-time interventions.
ABSTRACT According to the functional ensemble of temperament (FET) model, individual differences in temperament arise from the balance of neurotransmitter systems also crucial for regulating circadian rhythms and sleep, suggesting a strong neurobiological link between temperament and sleep behavior. The present cross‐sectional study examined whether FET‐defined temperamental traits predict interindividual variation in sleep measures. A total of 394 healthy adults completed the Structure of Temperament Questionnaire (STQ‐77) and validated measures of sleep quality, insomnia severity, daytime sleepiness, and presleep arousal, together with indices of anxiety and depression. Several temperamental traits showed robust associations with sleep outcomes. Neuroticism and impulsivity were associated with poorer sleep quality, greater insomnia severity, and heightened presleep cognitive arousal; these effects were largely mediated by anxiety and depression. Higher social tempo was associated with better sleep and reduced daytime sleepiness. Additional associations emerged for empathy, probabilistic thinking, plasticity, and physical endurance, indicating that orientation, integration, and maintenance FET systems contribute to shaping sleep behavior. These findings indicate that stable, neurochemically grounded temperamental traits may shape interindividual sleep differences, with affective distress as a central mediator. Integrating temperament models into sleep research provides a biologically coherent framework for identifying both risk and resilience factors and informs personalized sleep interventions.
S. Lasaponara, A. Scuderi, Elisa Pellegrini et al.· Personality and Mental Healt...· 0 citations
BACKGROUND
Suicidal ideation (SI) represents a severe consequence of major depressive disorder (MDD). While sleep disorders and immune dysregulation are associated with SI, the precise associations and complex mediating pathways involving sleep disturbances, inflammatory biomarkers, and anxiety and depression severity remain poorly understood.
METHODS
A total of 157 patients suffering from MDD were enrolled. Based on Item 3 of the 17-item Hamilton Depression Rating Scale (HAMD), participants were categorized into SI and non-suicidal ideation (NSI) groups. Sleep disorders were assessed using the Pittsburgh Sleep Quality Index (PSQI). Peripheral inflammatory markers were from complete blood counts. Spearman correlation analysis and multiple logistic regression methods were employed to analyze the associations of sleep disorders, emotional symptoms, and inflammatory markers with SI. Additionally, a bidirectional mediation analysis was conducted to explore the association of these variables with SI.
RESULTS
Patients with SI exhibited poorer sleep quality and altered inflammatory profiles. Significant correlations were observed among affective symptoms, sleep measures, and immune markers. The results showed that in models excluding emotional symptoms, the global PSQI score and sleep disturbances component were associated with SI. Mediation analysis indicates that the percentage of lymphocytes was indirectly associated with SI via the sleep disturbances and daytime dysfunction components. The daytime dysfunction component and HAMA score were associated with SI through bidirectional mediating pathways.
CONCLUSIONS
Sleep disorders, inflammatory dysregulation, and anxiety symptoms constitute an interconnected network associated with SI in MDD. These findings highlight the importance of comprehensive, integrated interventions.
Cailing Wei, Yudan Zhang, Yuan Gao et al.· Journal of Affective Disorde...· 0 citations
Abstract Background and hypothesis Psychotic-like experiences (PLEs) confer increased risk for adverse mental health outcomes. Sleep disturbances are associated with PLEs, yet evidence largely relies on retrospective assessments and average sleep parameters, limiting insight into daily-life dynamics. Moreover, the roles of stress exposure in sleep–PLEs associations remain insufficiently understood. This study aimed to address these gaps by examining sleep characteristics, momentary stress, and childhood trauma in relation to PLEs using experience sampling. We hypothesized that individuals with PLEs show poorer and more variable sleep, bidirectional sleep–PLEs associations, stronger stress-related sleep disturbances, and trauma-related alterations in sleep regulation. Study Design Altogether, 99 individuals with PLEs and 102 controls completed the experience sampling across 7 consecutive days. Study Results Individuals with PLEs reported poorer average sleep quality, shorter sleep duration, and greater variability in sleep quality, although differences in sleep quality and its variability were attenuated after adjustment for negative affect. Within the PLEs group, sleep quality, but not sleep duration, showed robust bidirectional within-person associations with PLEs. Daily stress fluctuations were not associated with next-morning sleep, whereas higher between-person stress exposure was related to poorer average sleep quality, with no moderation by PLEs group status. Childhood trauma was not significantly associated with sleep outcomes. Conclusions Reduced sleep duration might be a stable feature of PLEs independent of negative affect, while sleep quality is dynamically linked to momentary PLEs. Sleep disturbances in individuals with PLEs seem more closely related to symptom dynamics than to momentary stress and distal developmental risk factors.
B. Misiak, Paulina Bagrowska, J. Samochowiec et al.· Schizophrenia bulletin· 0 citations
Insomnia disorder is clinically heterogeneous, with variation in objective sleep duration, sleep perception, cognitive-emotional features, and spontaneous neural activity. We examined whether insomnia with normal sleep duration (INSD) has a distinct behavioral and neural profile relative to insomnia with short sleep duration (ISSD). In 233 participants (100 healthy controls, 67 INSD, 66 ISSD), we assessed objective and diary-based sleep, presleep arousal, and emotion regulation; resting-state fMRI was additionally acquired in a subset of 133 patients with insomnia. Analyses included group comparisons, phenotype-specific associations, moderated mediation, voxel-wise z-standardized amplitude of low-frequency fluctuation (zALFF), and exploratory brain-behavior partial least squares (PLS). Both insomnia groups reported poorer subjective sleep than controls. As expected from the phenotype definitions, INSD showed greater sleep misperception than ISSD; the novel findings were that INSD also showed greater presleep cognitive arousal and brooding, distinct regional zALFF alterations, and a conditional indirect association linking brooding to sleep misperception via presleep cognitive arousal that was evident in INSD but not ISSD. Compared with ISSD, INSD showed higher zALFF in the left insula, left hippocampus, and right precuneus, and lower zALFF in the right middle occipital gyrus. Exploratory PLS linked this INSD-like zALFF pattern to a behavioral profile dominated by sleep misperception and presleep cognitive arousal, mainly at the phenotype level. These findings suggest that INSD involves convergent cognitive-emotional and neural features related to sleep misperception, while causal and individual-prediction claims remain premature.
Background: Bidirectional next-day associations between sleep disturbances and affective symptoms have been shown in previous research, yet the consecutive day effects between these factors remains poorly understood. Methods: We analysed longitudinal ecological momentary assessment (EMA) data obtained from a subsample of young persons in the Brazilian High-Risk Cohort (BHRC) study collected in 2020-2021. Participants reported sleep quality each morning and rated affective symptoms relating to mood, anxiety, and energy four times daily for 28 days. We selected 88 individuals (17.83{+/-}1.74 years, 56 [63.6%] female gender) with at least one instance where individuals were observed three-days in a row. Within-person bidirectional next-day effects between sleep quality and affective symptoms were estimated using mixed-effects regression analysis adjusting. We then applied g-estimation approaches to estimate the effect that lagged sleep quality and consecutive improvements in sleep quality had on affective symptoms. Results: Sleep quality and affective symptoms had bidirectional next-day effects, with sleep quality tending to have greater influence on affective symptoms than the reverse. Improved lagged sleep quality had positive effects on affective symptoms incrementally above the prior night's sleep quality. Also, improvement of sleep quality across consecutive days had incremental and approximately equal effects on affective symptoms. Conclusions: Sleep quality and affective symptoms exhibit a feedback loop, whereby poor sleep quality influences affective symptoms over consecutive days. Breaking these feedback loops, by improving sleep quality across several consecutive nights should improve affective symptoms. This supports interventions that target sustained improvement in sleep and possibly circadian regulation to improve affective symptoms.
M. Varidel, L. Borgnolo, V. An et al.· medRxiv· 0 citations
Investigation of cross-sectional associations between objective sleep features (sleep duration, duration variability, and onset time) and mental health outcomes in 1371 U.S. adolescents found objective sleep features were differentially associated with mental health outcomes.
S. Izabel, Orsolya Kiss, Adam J. Krause et al.· npj Mental Health Research· 0 citations