Social exclusion prevents us understanding the role of sleep in psychosis and “schizophrenia”

The purpose of this paper is to discuss recent papers on trauma, sleep and psychotic experiences to highlight the lack of attention given to sleep.

A search was carried out to find recent papers on psychosis or schizophrenia, trauma and sleep.

Papers tended to focus on trauma and psychosis, or on sleep and psychosis, but not on trauma, sleep and psychosis. The two papers discussed in most detail here focussed on sleep difficulties from either a service user or professional perspective. Both concluded that sleep difficulties need more attention. The author also discussed evidence suggesting that stress and trauma cause sleep difficulties and that these, in turn, are an important cause of psychotic experiences. Severe or prolonged stress may also directly cause some psychotic experiences.

The two main papers highlight for the first time in detail service users’ own experiences of sleep difficulties, and how mental health professionals view them, suggesting more help is needed. Other papers suggest that sleep is overlooked in research into the causes of psychosis. There is growing evidence that people have sleep problems before psychotic experiences, and that many have experienced severe or prolonged stress due to life events and circumstances, often in childhood. Given that stress can interfere with sleep, it is time to investigate further the role of stress and sleep in the development and maintenance of psychosis.