Sleep Disturbances in Female Adolescents With Borderline Personality Disorder: A 5-Year Longitudinal Study

Sleep disturbances are commonly reported in individuals with borderline personality disorder (BPD) and are often worsened by comorbid mental health disorders such as ADHD, PTSD, and depression. Sleep problems may contribute to the persistence of symptoms, highlighting the importance of early identification and treatment of sleep disturbances as part of early intervention strategies. Despite this, the prevalence and predictors of persistent sleep problems in the early course of BPD remain understudied, particularly in longitudinal designs. In this study, we followed up on 110 female adolescents with BPD pathology 5 years after being included in the study to investigate the prevalence and predictors of sleep problems collected using a semistructured interview as participants transitioned into early adulthood. At baseline, BPD severity, ADHD, and melatonin use were associated with sleep disturbances. However, at 5-year follow-up, baseline ADHD, depression severity, and melatonin use emerged as the strongest predictors of persistent sleep problems, while BPD severity was no longer predictive. These findings underscore the complex interplay between comorbid mental health disorders and the development and maintenance of sleep problems in BPD. Targeting adolescents with BPD and severe sleep disturbances requiring medical intervention, comorbid ADHD, and significant depressive symptoms is crucial for alleviating persistent sleep problems. Integrating specific sleep interventions into early treatment strategies represents sound clinical management in the early stages of BPD, and future research should explore whether targeted interventions for these risk factors can mitigate long-term sleep-related challenges and improve overall outcomes for individuals with BPD.