Understanding the Sleep Problems of Young People in Mental Health Services, Their Links to Mental Health Difficulties and Impact on Intervention Effectiveness

Dhungana, Asmita (2025) Understanding the Sleep Problems of Young People in Mental Health Services, Their Links to Mental Health Difficulties and Impact on Intervention Effectiveness. Doctoral thesis, University of East Anglia.

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Abstract

Background: Young people face major sleep changes and heightened risk for mental health problems. Due to the bidirectional sleep-mental health link, transdiagnostic sleep interventions report improvements for sleep and mental health. Yet little is known about how insomnia and lesser studied difficulties like nightmares, circadian disruption, sleep paralysis and sleep-related hallucinations present in young people with mental health problems, how they interact with mental health, and affect insomnia treatment response in clinical populations. Understanding these could improve sleep interventions in youth mental health care.

Methods: A systematic review synthesised 36 peer-reviewed studies on impact of comorbid insomnia on youth with mental health difficulties using a narrative synthesis approach. An empirical study was conducted of a secondary analysis of anonymised data from 14–25-year-olds accessing a CBT-I-informed sleep intervention within youth mental health services. It examined the prevalence and correlates of specific sleep disturbances—insomnia, nightmares, circadian rhythm disruptions, and unusual sleep experiences—and explored predictors of treatment response.

Results: This thesis found that comorbid insomnia was consistently associated with worsened mental health severity and functioning yet responded well to treatment using CBT-I among young people with mental health problems, seemingly with effectiveness not affected by co-occurring sleep difficulties or mental health severity. The empirical study found high rates of comorbid sleep disturbances in young people with mental health and insomnia difficulties. Nightmares and unusual sleep experiences were associated with greater clinical severity, with nightmares also linked to worse functioning.

Conclusions: Comorbid insomnia and related sleep disturbances are prevalent and clinically significant among youth with mental health difficulties. CBT-I-informed interventions are effective in reducing insomnia even in the presence of comorbid sleep or mental health problems, supporting their integration into youth services. Future research should investigate mechanisms of comorbidity and expand controlled trials to optimise sleep-focused care in youth mental health.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	09 Dec 2025 08:55
Last Modified:	09 Dec 2025 08:55
URI:	https://ueaeprints.uea.ac.uk/id/eprint/101342
DOI:

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