The sleep phenotype of Borderline Personality Disorder: A systematic review and meta-analysis

Research output: Contribution to journalReview articlepeer-review


  • Catherine Winsper
  • Nicole K Y Tang
  • Suzet Tanya Lereya
  • Melanie Gibbs
  • Andrew Thompson
  • Swaran P Singh

Colleges, School and Institutes

External organisations

  • Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, UK. Electronic address:
  • Department of Psychology, University of Warwick
  • Evidence Based Practice Unit (EBPU), University College London and the Anna Freud Centre, London, UK.
  • Centre for Applied Social and Psychological Development, Canterbury Christchurch University, UK.
  • Mental Health and Wellbeing, Division of Health Sciences,Warwick Medical School, University of Warwick,Coventry,UK.


AIM: To delineate the sleep profile of Borderline Personality Disorder (BPD).

METHOD: A meta-analysis to synthesise findings on the objective and subjective sleep characteristics of BPD.

RESULTS: We identified 32 studies published between 1980 and December 2015. Meta-analysis indicated significant differences between BPD and healthy control groups across objective sleep continuity (sleep onset latency, total sleep time, sleep efficiency) and architecture (rapid eye movement latency/density, slow wave sleep) measures, and self-reported sleep problems (nightmares, sleep quality). Findings were independent of depression (in clinical and community populations), and concomitant psychotropic medication use. There were few significant differences between BPD and clinical (majority depressed) control groups.

CONCLUSION: BPD is associated with comparable sleep disturbances to those observed in depression. These disturbances are not solely attributable to comorbid depression. Given growing evidence that sleep disturbance may exacerbate emotional dysregulation and suicide risk, treatments for BPD should explicitly address sleep problems. Future studies should utilise prospective designs to ascertain whether (and in which circumstances) sleep problems predate or follow the onset of the disorder.


Original languageEnglish
Pages (from-to)48-67
Number of pages20
JournalNeuroscience and biobehavioral reviews
Early online date15 Dec 2016
Publication statusPublished - Feb 2017


  • Borderline Personality Disorder, Humans, Phenotype, Sleep, Sleep Wake Disorders