Sleep in Serious Mental Illness: Impact on patients and treatment in services

Stafford, Aviva (2024) Sleep in Serious Mental Illness: Impact on patients and treatment in services. Doctoral thesis, University of East Anglia.

Preview

PDF Download (2MB) | Preview

Abstract

This thesis explored sleep in the context of serious mental illness (SMI), firstly by investigating the association between sleep and socio-occupational functioning (SOF), and then by investigating how sleep is recorded and treated in current clinical practice, as well as its association with attendance and number of appointments scheduled.

A systematic review was conducted to collate existing research on sleep and SOF in SMI. Comprehensive searches were performed in PubMed and PsycNet, yielding 832 results. After applying inclusion criteria, 24 studies were included. Data were extracted for analysis via narrative synthesis. Collectively, studies investigated sleep quality, satisfaction, duration, disturbance, specific disorders, and objectively-recorded sleep parameters across various study designs and assessment methods. Most studies revealed a significant association between the respective sleep problem(s) and SOF in SMI populations. While limitations such as reliance on primarily subjective measures and the need for randomised controlled trials were identified, the review emphasises the need for sleep assessment and integrated sleep interventions as part of routine SMI care to potentially improve and/or prevent poor SOF.

An empirical study was then carried out to examine the documentation and treatment of sleep problems in records of SMI patients, the association between their sleep and attendance rates and the association between their sleep and number of appointments scheduled. Relevant patient records (n = 133) were extracted from an NHS Trust’s electronic database via automatic and manual selection processes. Quantitative content analyses and follow-up chi-square analyses were used to answer the recording and treatment research questions. Mann-Whitney U tests were used to compare attendance rates and number of appointments scheduled by sleep status. Findings revealed that there is inconsistency in the recording of relevant sleep information of SMI patients, and records are often limited to one-word descriptions. Sleep status was not associated with attendance rate or number of appointments scheduled, though low numbers limited this finding. The study echoes previous research regarding the inadequate assessment of sleep and the discrepancy between recognised sleep problems and subsequent treatment adherence to NICE guidelines (e.g., CBT-I, a recommended first-line treatment, was rarely offered). The study highlights the need for improved recording and consistent treatment of sleep by clinicians, to align with NICE guidelines, and suggests relevant areas for further research.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	07 Nov 2024 09:49
Last Modified:	07 Nov 2024 09:49
URI:	https://ueaeprints.uea.ac.uk/id/eprint/97553
DOI:

Downloads

Actions (login required)

View Item