Preprint
Longer Sleep Duration Predicts Progression to Bipolar or Psychotic Disorders in Youth accessing Early Intervention Mental Health Services
medRxiv, Vol.5 March 2026
Cold Spring Harbor Laboratory Press
2026
PMID: 41822684
Appears in Thompson Institute Research Collection
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 6+ months (up to 8 years; median 2.5 years). Logistic regression and Cox proportional hazard 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 - 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
- medRxiv, Vol.5 March 2026
- Publisher
- Cold Spring Harbor Laboratory Press
- Date published
- 2026
- DOI
- 10.64898/2026.03.04.26347669
- PMID
- 41822684
- Copyright note
- The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC 4.0 International license.
- Data Availability
- All data produced in the present study are available upon reasonable request to the authors
- 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
- 991216245202621
- Output Type
- Preprint
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