The Sleep Detectives: Sleep stratification in young people at high risk of psychosis

Large-scale psychiatric genomics studies have catalogued a suite of chromosomal deletions or duplications (copy number variants, CNVs) associated with significantly increased risk of intellectual dysfunction and neurodevelopmental disorders, including schizophrenia. How can we predict which/when ‘psych-CNV’ carriers will present with psychosis, amongst a complex spectrum of other symptoms? What are the biological routes from psych-CNV to impaired cognition? Our recent work shows that >60% of children carrying psych-CNVs have high risk of early-onset insomnia and restless sleep. We have also detected abnormal sleep-dependent EEG oscillations in young people with 22q11.2 deletion syndrome, which associate with cognitive impairment and clinical symptoms indicative of future psychotic disorder. We therefore propose to work with young psych-CNV carriers to map links between sleep problems and daily challenges arising from impaired memory, attention and social interactions. Allying longitudinal, at-home monitoring of activity and EEG with clinical and cognitive assessments, MEG-based metrics of neural information processing and computational psychiatry, we aim to stratify patients according to high-resolution neurophysiological and behavioural phenotypes, embedding sleep science and patient/carer engagement in a translational framework for personalised psychiatry.