治疗被监禁者的失眠症:多成分治疗路径的可行性研究

L. Dewa, B. Thibaut, Natalie Pattison, Sean James Campbell, Thomas Woodcock, Paul Aylin, Stephanie Archer
{"title":"治疗被监禁者的失眠症:多成分治疗路径的可行性研究","authors":"L. Dewa, B. Thibaut, Natalie Pattison, Sean James Campbell, Thomas Woodcock, Paul Aylin, Stephanie Archer","doi":"10.1093/sleepadvances/zpae003","DOIUrl":null,"url":null,"abstract":"\n Around 60% of people who are incarcerated have insomnia; 6-10 times more prevalent than the general population. Yet, there is no standardised, evidence-based approach to insomnia treatment in prison. We assessed the feasibility of a treatment pathway for insomnia in a high-secure prison to inform a future randomised controlled trial (RCT) and initial efficacy data for sleep and mental health outcomes. We used a within-subjects pre-post design. The stepped-care pathway included: self-management with peer support, environmental aids, and cognitive behavioural therapy for insomnia (CBTi). Assessment measures for insomnia, wellbeing, mood, anxiety, suicidality, overall health, sleepiness, fatigue, and cognitive functioning were administered at baseline and pathway exit. Feasibility criteria included eligibility to participate, CBTi uptake and assessment completion. Forty-two adult males who are incarcerated were approached of which 95.2% were eligible. Of those deemed eligible, most participated (36/40, 90.0%). Most who completed baseline completed post-assessments (28/36, 77.8%) and of these, most showed improvements in their subjective sleep (27/28, 96.4%). Large reductions were found from pre- to post-treatment in insomnia severity (d=-1.81, 95% CIs 8.3 to 12.9) and 57.0% reported no clinically significant insomnia symptoms at post-assessment. There was no overall change in actigraphy-measured sleep. Large treatment benefits were found for depression, anxiety, wellbeing, and cognitive functioning, with a medium benefit on suicidal ideation. The treatment pathway for insomnia in prison was feasible and may be an effective treatment for insomnia in people who are incarcerated, with additional promising benefits for mental health. A pragmatic RCT across different prison populations is warranted.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":"7 9","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Treating insomnia in people who are incarcerated: a feasibility study of a multi-component treatment pathway\",\"authors\":\"L. Dewa, B. Thibaut, Natalie Pattison, Sean James Campbell, Thomas Woodcock, Paul Aylin, Stephanie Archer\",\"doi\":\"10.1093/sleepadvances/zpae003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"\\n Around 60% of people who are incarcerated have insomnia; 6-10 times more prevalent than the general population. Yet, there is no standardised, evidence-based approach to insomnia treatment in prison. We assessed the feasibility of a treatment pathway for insomnia in a high-secure prison to inform a future randomised controlled trial (RCT) and initial efficacy data for sleep and mental health outcomes. We used a within-subjects pre-post design. The stepped-care pathway included: self-management with peer support, environmental aids, and cognitive behavioural therapy for insomnia (CBTi). Assessment measures for insomnia, wellbeing, mood, anxiety, suicidality, overall health, sleepiness, fatigue, and cognitive functioning were administered at baseline and pathway exit. Feasibility criteria included eligibility to participate, CBTi uptake and assessment completion. Forty-two adult males who are incarcerated were approached of which 95.2% were eligible. Of those deemed eligible, most participated (36/40, 90.0%). Most who completed baseline completed post-assessments (28/36, 77.8%) and of these, most showed improvements in their subjective sleep (27/28, 96.4%). Large reductions were found from pre- to post-treatment in insomnia severity (d=-1.81, 95% CIs 8.3 to 12.9) and 57.0% reported no clinically significant insomnia symptoms at post-assessment. There was no overall change in actigraphy-measured sleep. Large treatment benefits were found for depression, anxiety, wellbeing, and cognitive functioning, with a medium benefit on suicidal ideation. The treatment pathway for insomnia in prison was feasible and may be an effective treatment for insomnia in people who are incarcerated, with additional promising benefits for mental health. A pragmatic RCT across different prison populations is warranted.\",\"PeriodicalId\":21861,\"journal\":{\"name\":\"SLEEP Advances\",\"volume\":\"7 9\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-01-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"SLEEP Advances\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/sleepadvances/zpae003\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"SLEEP Advances","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/sleepadvances/zpae003","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

约有 60% 的被监禁者患有失眠症,是普通人群的 6-10 倍。然而,监狱中的失眠治疗还没有标准化的循证方法。我们对高度戒备监狱中失眠治疗路径的可行性进行了评估,以便为未来的随机对照试验(RCT)以及睡眠和心理健康结果的初步疗效数据提供参考。我们采用了受试者内前-后设计。阶梯式护理路径包括:同伴支持下的自我管理、环境辅助和失眠认知行为疗法(CBTi)。在基线和退出路径时,对失眠、幸福感、情绪、焦虑、自杀倾向、整体健康、嗜睡、疲劳和认知功能进行评估。可行性标准包括参与资格、接受 CBTi 和完成评估。研究人员接触了 42 名成年男性囚犯,其中 95.2% 符合条件。在被认为符合条件的人中,大多数人都参加了(36/40,90.0%)。大多数完成基线评估的人都完成了后期评估(28/36,77.8%),其中大多数人的主观睡眠状况有所改善(27/28,96.4%)。从治疗前到治疗后,失眠严重程度大幅降低(d=-1.81,95% CIs 为 8.3 至 12.9),57.0% 的人在治疗后的评估中没有出现明显的临床失眠症状。用动电仪测量的睡眠情况总体上没有变化。抑郁、焦虑、幸福感和认知功能方面的治疗效果显著,自杀意念方面的治疗效果中等。监狱中失眠症的治疗路径是可行的,可能是治疗被监禁者失眠症的有效方法,并有望对心理健康产生额外的益处。有必要在不同的监狱人群中进行务实的 RCT 研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Treating insomnia in people who are incarcerated: a feasibility study of a multi-component treatment pathway
Around 60% of people who are incarcerated have insomnia; 6-10 times more prevalent than the general population. Yet, there is no standardised, evidence-based approach to insomnia treatment in prison. We assessed the feasibility of a treatment pathway for insomnia in a high-secure prison to inform a future randomised controlled trial (RCT) and initial efficacy data for sleep and mental health outcomes. We used a within-subjects pre-post design. The stepped-care pathway included: self-management with peer support, environmental aids, and cognitive behavioural therapy for insomnia (CBTi). Assessment measures for insomnia, wellbeing, mood, anxiety, suicidality, overall health, sleepiness, fatigue, and cognitive functioning were administered at baseline and pathway exit. Feasibility criteria included eligibility to participate, CBTi uptake and assessment completion. Forty-two adult males who are incarcerated were approached of which 95.2% were eligible. Of those deemed eligible, most participated (36/40, 90.0%). Most who completed baseline completed post-assessments (28/36, 77.8%) and of these, most showed improvements in their subjective sleep (27/28, 96.4%). Large reductions were found from pre- to post-treatment in insomnia severity (d=-1.81, 95% CIs 8.3 to 12.9) and 57.0% reported no clinically significant insomnia symptoms at post-assessment. There was no overall change in actigraphy-measured sleep. Large treatment benefits were found for depression, anxiety, wellbeing, and cognitive functioning, with a medium benefit on suicidal ideation. The treatment pathway for insomnia in prison was feasible and may be an effective treatment for insomnia in people who are incarcerated, with additional promising benefits for mental health. A pragmatic RCT across different prison populations is warranted.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
A Central Role of Sulcal Width in the Associations of Sleep Duration and Depression with Cognition in Mid to Late Life Clinical and Financial Significance of Insomnia within a Large Payor-Provider Health System Impact of Real-World Implementation of Evidence-Based Insomnia Treatment within a Large Payor-Provider Health System: Initial Provider and Patient-Level Outcomes Poor Sleep and Inflammatory Gene Expression Among Care Partners of Persons Living with Dementia: A Pilot Trial of a Behavioral Sleep Intervention Sex-Specific Associations Between Habitual Snoring and Cancer Prevalence: Insights from a U.S. Cohort Study
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1