Daily Predictors of Psychotic‐Like Experiences in Older Adults: The Role of Sleep Quality, Negative Emotions, and Cognitive Failures

In older adults aged 50-79, poorer subjective sleep quality is linked to more psychotic-like experiences the next day, and this relationship is mediated by negative emotions during the morning and in dreams. Over a 7-day home-based study with 72 participants, those who reported worse sleep quality also reported more subclinical psychotic symptoms the following day, with negative emotions playing a key mediating role. Higher subjective cognitive failures and lower IQ were also associated with more psychotic-like experiences, while objective sleep measures showed no connection. The findings suggest that sleep, emotions, and cognitive function together contribute to daytime psychotic-like experiences in older adults.

Study at a glance

Abstract

Psychotic-like experiences are subclinical psychotic symptoms that are usually accompanied by sleep problems, negative emotions, and poorer cognitive functioning. However, their night-to-day associations remain understudied in older adults. 72 participants aged 50-79 took part in a home-based sleep study. After an intelligence test, they reported their sleep quality, dream and morning emotions, psychotic-like experiences, and subjective cognitive failures for 7 days, in addition to wearing an electroencephalographic headband. Results showed that poorer subjective sleep quality was associated with higher levels of psychotic-like experiences the following day, a relationship mediated by negative morning and dream emotions. Furthermore, higher subjective cognitive failures and lower IQ were related to more psychotic-like experiences. Objective sleep parameters were not linked to next-day psychotic-like experiences. The results demonstrate that negative emotions play a mediating role between poor sleep quality and psychotic-like experiences in older adults. Additionally, improved cognitive performance, both subjective and objective, seems to protect against the occurrence of psychotic-like experiences. The study indicates that sleep, emotions, and cognitive functions are key contributors to daytime psychotic-like experiences in older adults.