Researchers from Oxford Health NHS Foundation Trust and the University of Oxford’s Department of Psychiatry and Population Health, with colleagues at Harvard Medical School, have published a study in JAMA Network Open that sheds new light on the relationship between sleep and psychosis.

The research was led by Dr Rosario Aronica and funded by the Wellcome Trust, with support form the NIHR Biomedical Research Centre (BRC): Oxford Health.

The study analysed data from 18 international studies involving 1,358 participants, including people at clinical high risk of developing psychosis, individuals with schizophrenia spectrum disorders, and healthy control participants. Using wrist-worn sleep trackers, researchers assessed a range of sleep measures including total sleep time, time spent in bed, sleep efficiency and periods of wakefulness during the night.

Rather than focusing solely on average sleep alterations, the team explored how much sleep differs between individuals. The findings showed greater variability in key sleep measures among people at risk of psychosis and those with schizophrenia spectrum disorders compared with healthy controls. Increased variability was found in time spent in bed, wakefulness after sleep onset and sleep efficiency. However, for total sleep time, higher variability was observed only among people with schizophrenia spectrum disorders.

The authors, including BRC Theme Leads Professor Philip McGuire and Associate Professor Amadeo Minichino and senior author Dr Dominic Oliver, suggest that these distinct patterns of sleep variability may help researchers better understand the diversity of experiences within psychotic disorders. The findings support further investigation into whether sleep could act as a biomarker to help identify different patient groups and inform more personalised approaches to care.

Dr Rosario Aronica

Dr Rosario Aronica, Consultant Psychiatrist at Oxford Health NHS Foundation Trust and lead author of the study, said: “Sleep alterations are common in people with psychosis, but looking at averages alone can mask important differences between these individuals. Our study found greater variability in several sleep measures across the psychosis spectrum, suggesting there may be distinct sleep profiles that warrant further investigation. As digital technologies make it easier to monitor sleep in everyday life, understanding these patterns could help inform future approaches to personalised mental healthcare.”

The study, Interindividual Sleep Variability Across the Psychosis Spectrum: A Systematic Review and Meta-Analysis, was published in JAMA Network Open on 22 July 2026