Participants described sleep difficulties as deeply interconnected with anxiety, low mood, paranoia, unusual experiences, and broader challenges in daily life. Accessing mental health support was often experienced as difficult and frustrating, whereas the sleep-focused intervention was valued for its flexibility, collaborative style, and personalised approach. Improvements in sleep were associated with wider benefits, including reduced distress, improved mood, increased confidence, and fewer psychotic-like experiences. Overall, the study highlights sleep as a meaningful and acceptable treatment target for young people at risk of psychosis, with the potential to improve multiple aspects of mental health and functioning.