Become your own SLEEPexpert: design, implementation and preliminary evaluation of a pragmatic behavioral treatment program for insomnia in inpatient psychiatric care.

Schneider, Carlotta Louisa; Hertenstein, Elisabeth; Fehér, Kristoffer; Maier, Jonathan Gabriel; Cantisani, Andrea; Moggi, Franz; Berger, Thomas; Nissen, Christoph (2020). Become your own SLEEPexpert: design, implementation and preliminary evaluation of a pragmatic behavioral treatment program for insomnia in inpatient psychiatric care. Sleep Advances, 1(1) Oxford Academic 10.1093/sleepadvances/zpaa005

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Study Objectives

The majority of patients with mental disorders suffer from insomnia, associated with adverse health outcomes. Cognitive behavioral therapy for insomnia (CBT-I) represents the first-line treatment, but is too complex for severely ill patients and not systematically implemented in inpatient psychiatric care. This project aimed to develop a pragmatic behavioral treatment program that empowers inpatients with severe mental disorders to take care of their own sleep health.
Methods

CBT-I was adapted based on implementation research involving 24 inpatients with psychiatric disorders across diagnostic entities and comorbid insomnia and 30 health care providers at the University Hospital of Psychiatry and Psychotherapy, Bern. The program was implemented and evaluated by 15 patients and 22 health care providers based on interviews and questionnaires before participation and prior to discharge.
Results

Implementation research resulted in the SLEEPexpert intervention, centering on bedtime restriction and circadian adaptation in three phases; therapist-guided treatment initiation, self-management with nursing support, and self-management. Evaluative pre-post assessments in 15 patients demonstrated feasibility. Time in bed decreased by 60 minutes (520 ± 105.3 vs. 460 ± 78.1, p = 0.031, d = 0.6) and total sleep time increased by around 45 minutes (331 ± 110.6 vs. 375 ± 74.6, p = 0.09, d = 0.5), resulting in increased sleep efficiency (65.3 ± 21.8 vs. 81.9 ± 11.2%, p = 0.011, d = 0.8). Patients improved on the Insomnia Severity Index (18.3 ± 4.6 vs. 11.4 ± 4.4, p < 0.001, d = 1.2) and Pittsburgh Sleep Quality Index (12.9 ± 3.8 vs. 10.3 ± 3.3, p = 0.031, d = 0.6).
Conclusions

We propose a new pragmatic behavioral treatment program (SLEEPexpert) customized to the needs of patients and health care providers in inpatient psychiatric care. Data demonstrate feasibility. An improvement of insomnia severity was observed, but a control comparison is needed to further test for efficacy.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Translational Research Center
07 Faculty of Human Sciences > Institute of Psychology > Clinical Psychology and Psychotherapy
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy
07 Faculty of Human Sciences > Institute of Psychology

UniBE Contributor:

Schneider, Carlotta Louisa; Hertenstein, Elisabeth; Fehér, Daniel Kristoffer; Maier, Jonathan Gabriel; Cantisani, Andrea; Moggi, Franz; Berger, Thomas and Nissen, Christoph

Subjects:

100 Philosophy > 150 Psychology
600 Technology > 610 Medicine & health

ISSN:

2632-5012

Publisher:

Oxford Academic

Language:

English

Submitter:

Ersilia Trinca

Date Deposited:

13 Jan 2021 12:03

Last Modified:

13 Jan 2021 12:11

Publisher DOI:

10.1093/sleepadvances/zpaa005

BORIS DOI:

10.7892/boris.150182

URI:

https://boris.unibe.ch/id/eprint/150182

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