Journal article
Longer Sleep Duration Predicts Progression to Bipolar or Psychotic Disorders in Youth Accessing Early Intervention Mental Health Services
Bipolar Disorders, Vol.28(7), pp.1-12
2026
PMID: 42755433
Abstract
Background
While growing evidence implicates sleep-wake and circadian rhythm disturbances (SCRDs) in the onset and course of mood and psychotic disorders, longitudinal studies using objective measures are limited. This clinical cohort study examined whether actigraphy-derived SCRDs (sleep duration, timing, and efficiency) predicted transition to (i) any full-threshold mental disorders; and then specifically; (ii) full-threshold bipolar or psychotic disorders; or (iii) other full-threshold (i.e., depressive or anxiety) disorders, in youth accessing mental health care.
Methods
Actigraphy monitoring was completed for 5–23 days in 250 participants (aged 12–30) presenting to youth-focused early intervention services in Sydney, Australia. Participants were followed longitudinally as part of the Optymise cohort for at least 6+ months (up to 8 years; median 2.5 years). Logistic regression and Cox proportional hazards models estimated associations between SCRDs and illness progression, after controlling for relevant baseline clinical and demographic covariates (e.g., age, sex, social and occupational functioning, mania-like and psychotic-like experiences, medication use).
Results
Longer sleep duration at baseline predicted higher odds of transition (OR = 2.23 [95% CI = 1.38–3.74]), and shorter time-to-transition (HR = 2.05 [95% CI = 1.23–3.40]) to full-threshold bipolar or psychotic disorders. This effect remained significant after controlling for clinical covariates. Later sleep midpoint predicted transition to any full-threshold mental disorder (OR = 1.46 [95% CI = 1.02–2.17]) at the uncorrected significance level.
Conclusions
Excessive sleep duration may represent an early marker of vulnerability for progression to severe mental illness. Findings support the prognostic utility of objective measures of SCRDs to guide indicated prevention and early intervention.
Details
- Title
- Longer Sleep Duration Predicts Progression to Bipolar or Psychotic Disorders in Youth Accessing Early Intervention Mental Health Services
- Authors
- Joanne S Carpenter (Corresponding Author) - The University of SydneyJacob J Crouse - The University of SydneyMathew Varidel - The University of SydneyEmiliana Tonini - The University of SydneyMirim Shin - The University of SydneyNatalia Zmicerevska - The University of SydneyAlissa Nichles - The University of SydneyDaniel F Hermens - University of the Sunshine CoastKathleen R Merikangas - National Institute of Mental HealthElizabeth M Scott - The University of SydneyIan B Hickie - The University of SydneyFrank Iorfino - The University of Sydney
- Publication details
- Bipolar Disorders, Vol.28(7), pp.1-12
- Publisher
- Wiley-Blackwell Publishing, Inc.
- Date published
- 2026
- DOI
- 10.1111/bdi.70183
- ISSN
- 1399-5618
- PMID
- 42755433
- Copyright note
- © 2026 The Author(s). Bipolar Disorders published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
- Data Availability
- The data that support the findings of this study are available from the corresponding author upon reasonable request.
- Grants
- Grant note
- Prof Merikangas was supported in part by grant Z-01-MH002804 and NIH Clinical protocol NCT00071786 from the National Institute of Mental Health (NIMH) Intramural Research Program.
- Organisation Unit
- Thompson Institute
- Language
- English
- Record Identifier
- 991261095902621
- Output Type
- Journal article
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