The effect of cognitive behavioural interventions on sleep effort

Bristowe, Henry (2024) The effect of cognitive behavioural interventions on sleep effort. Doctoral thesis, University of East Anglia.

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Abstract

Insomnia is a common sleep disorder distinguished by difficulty with initiating or maintaining sleep. Insomnia both distressing for the individual and costly at a societal level. There are a number of cognitive and behavioural models and interventions developed to treat insomnia. These models propose a variety of mechanisms . Of these, sleep effort (consciously engaging in behaviours that are intended to initiate sleep onset) is emerging as an important maintenance factor. This thesis portfolio aims to explore how sleep effort is affected by cognitive-behavioural treatment. First, a systematic review and meta-analysis is described in which randomised control trials that measure the effect of cognitive-behavioural interventions on sleep effort are identified and relevant data is synthesised to determine the overall effect of these interventions on sleep effort. Second, an empirical research project is reported where an intervention specifically designed to target sleep effort is implemented (paradoxical intention therapy) to examine its effect on both sleep effort and sleep characteristics. A novel aspect of this study is that it utilises an EEG headband to measure objective sleep characteristics. In the systematic review, six relevant studies were identified. The meta-analysis yielded a significant effect of cognitive-behavioural interventions on sleep effort with a medium effect size. In the empirical paper, the intervention was found to have a significant effect on sleep effort, global insomnia symptoms (self-report questionnaire derived) and sleep diary reported sleep onset latency. However, no significant effects were found for any of the other sleep characteristics including all objective sleep parameters. This thesis concludes by noting the significant effect that cognitive-behavioural interventions have overall on sleep effort and considers clinical implications of the research described and future directions.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Nicola Veasy
Date Deposited:	07 Nov 2024 09:06
Last Modified:	07 Nov 2024 09:06
URI:	https://ueaeprints.uea.ac.uk/id/eprint/97547
DOI:

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