How is insomnia related to psychosis?

Insomnia and psychosis are closely related, as insomnia can precede, maintain, and worsen psychotic symptoms. People with psychotic disorders often experience dopamine surges at night, which contributes to difficulty sleeping.

Insomnia can appear weeks or months before psychotic symptoms manifest, and nearly 50% of people with psychotic disorders continue to experience sleep problems after a psychotic episode. This sleep disorder can exacerbate psychotic experiences such as paranoia and, to a lesser extent, hallucinations, creating a vicious cycle where poor sleep worsens psychotic symptoms, which in turn hinder rest.