Large-scale implementation of insomnia treatment in routine psychiatric care: patient characteristics and insomnia-depression comorbidity

The objective of this study was to compare comorbidity and patient characteristics among patients having treatment for depression before and after implementation of cognitive behavioural therapy for insomnia (CBT-I) in a routine care internet treatment clinic. We hypothesized that insomnia comorbidity would be lower among patients having treatment for depression after the treatment for insomnia became available, and that depression levels would be high among patients in the insomnia treatment group compared to previous studies of insomnia. Patients were assessed face-to-face by physicians and guided through internet-delivered treatment by psychologists in a psychiatric setting. We retrieved patient data from 3 years before and 3 years after the CBT-I implementation. Measures were the Montgomery-Åsberg Depression Rating Scale-Self rated (MADRS-S) and Insomnia Severity Index (ISI). Pretreatment symptom levels were high in both the depression (MADRS-S = 23, n = 1467) and insomnia treatment (ISI = 20, n = 552) groups, indicating a true psychiatric sample. Contrary to the hypothesis, there were no significant changes in the group having treatment for depression regarding insomnia severity or comorbid insomnia diagnosis (from 66% to 68%) after CBT-I implementation. Also contrary to the hypothesis, comorbid depression levels among insomnia patients having CBT-I were similar to or slightly higher than in previous studies. It is likely that more patients with this comorbidity, w...
Source: Journal of Sleep Research - Category: Sleep Medicine Authors: Source Type: research

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AbstractSleep disorders are linked to development of type 2 diabetes and increase the risk of developing diabetes complications. Treating sleep disorders might therefore play an important role in the prevention of diabetes progression. However, the detection and treatment of sleep disorders are not part of standardised care for people with type 2 diabetes. To highlight the importance of sleep disorders in people with type 2 diabetes, we provide a review of the literature on the prevalence of sleep disorders in type 2 diabetes and the association between sleep disorders and health outcomes, such as glycaemic control, microv...
Source: Diabetologia - Category: Endocrinology Source Type: research
CONCLUSIONS: Significant clinical benefit was associated with the introduction of an evidence-based digital sleep intervention alongside other mental health interventions for depression and anxiety. Widespread deployment was achieved with immediate availability, minimal additional clinical time or staff training. This approach provides a feasible and highly scalable model for improving mental health outcomes in clinical services.PMID:34246110 | DOI:10.1016/j.brat.2021.103922
Source: Behaviour Research and Therapy - Category: Psychiatry & Psychology Authors: Source Type: research
CONCLUSIONS: A scalable CBT sleep intervention is efficacious in buffering against sleep disturbance during pregnancy and benefitted sleep at 2-year postpartum, especially for individuals with insomnia symptoms during pregnancy. The intervention holds promise for implementation into routine perinatal care.PMID:34231450 | DOI:10.1017/S0033291721001860
Source: Psychological Medicine - Category: Psychiatry Authors: Source Type: research
Prisoner’s insomnia prevalence, insomnia associated factors and interventions with sleep as an outcome: a review and narrative analysis Chris Griffiths, Farah Hina International Journal of Prisoner Health, Vol. ahead-of-print, No. ahead-of-print, pp.- Insomnia is highly prevalent in prisoners. The purpose of this paper is a review of research evidence on interventions with sleep as an outcome (2000 to 2020) and rates of insomnia prevalence and associated factors in prisons (2015 to 2020). An internet-based search used Medline, PubMed, PsycINFO (EBSCOhost), Embase, Web of Science and Scopus. Seven...
Source: International Journal of Prisoner Health - Category: Criminology Authors: Source Type: research
Int J Prison Health. 2021 Jul 6;ahead-of-print(ahead-of-print). doi: 10.1108/IJPH-01-2021-0014.ABSTRACTPURPOSE: Insomnia is highly prevalent in prisoners. The purpose of this paper is a review of research evidence on interventions with sleep as an outcome (2000 to 2020) and rates of insomnia prevalence and associated factors in prisons (2015 to 2020).DESIGN/METHODOLOGY/APPROACH: An internet-based search used Medline, PubMed, PsycINFO (EBSCOhost), Embase, Web of Science and Scopus. Seven interventions and eight sleep prevalence or sleep-associated factor papers were identified.FINDINGS: Intervention research was very limite...
Source: International Journal of Prisoner Health - Category: Criminology Authors: Source Type: research
Antidepressants are widely used for depression and anxiety. Guidelines recommend that an antidepressant should be continued for at least six months after people start to feel better, and for at least two years if they have had two or more periods of depression. Many people take antidepressants for much longer. Ellen Van Leeuwen and Mark Horowitz, authors of arecently published Cochrane review on approaches for discontinuing antidepressant use, answer some questions about the findings of the review.  Tell us about this Cochrane Review, why did you think it was important to do it?Ellen: The rise in long-term antidepress...
Source: Cochrane News and Events - Category: Information Technology Authors: Source Type: news
Addressing the mental health crisis (Pharma Field): Each day we find out more about the mental health effects of the pandemic. Early on, the Office for National Statistics found that one in five Britons reported symptoms of depression, compared with one in 10 before. And, according to a recent study led by the University of Nottingham and King’s College London, stress, anxiety and depression were all significantly higher in participants compared with ‘population norms’, with 64% of the participants reporting symptoms of depression and 57% reporting symptoms of anxiety. … Through simple force of nec...
Source: SharpBrains - Category: Neuroscience Authors: Tags: Brain/ Mental Health Technology & Innovation advertising standards cognitive behavioural therapy consumer protection digital health digital health applications digital mental health digital mental health interventions digital therapeutic Source Type: blogs
Abstract Cognitive behavioural therapy for insomnia is the recommended treatment for chronic insomnia. However, up to a quarter of patients dropout from cognitive behavioural therapy for insomnia programmes. Acceptance, mindfulness and values-based actions may constitute complementary therapeutic tools to cognitive behavioural therapy for insomnia. The current study sought to evaluate the efficacy of a remotely delivered programme combining the main components of cognitive behavioural therapy for insomnia (sleep restriction and stimulus control) with the third-wave cognitive behavioural therapy acceptance and comm...
Source: Journal of Sleep Research - Category: Sleep Medicine Authors: Tags: J Sleep Res Source Type: research
We examined the effects of a fully-automated digital cognitive behavioural therapy intervention for insomnia (Sleepio) on insomnia and depressive symptoms, and the mediating role of sleep improvement on depressive symptoms in participants from two randomized controlled trials of digital cognitive behavioural therapy for insomnia. We also explored potential moderators of intervention effects. All participants met criteria for probable insomnia disorder and had clinically significant depressive symptomatology (PHQ-9 ≥ 10; n = 3,352). Individuals allocated to treatment in both trials were provided acces...
Source: Journal of Sleep Research - Category: Sleep Medicine Authors: Tags: J Sleep Res Source Type: research
Prevalence and management of chronic insomnia in Swiss primary care: Cross-sectional data from the "Sentinella" practice-based research network. J Sleep Res. 2020 Jun 25;:e13121 Authors: Maire M, Linder S, Dvořák C, Merlo C, Essig S, Tal K, Del Giovane C, Syrogiannouli L, Duss SB, Heinzer R, Nissen C, Bassetti CLA, Auer R Abstract We investigated the prevalence and treatment of patients with chronic insomnia presenting to Swiss primary care physicians (PCPs) part of "Sentinella", a nationwide practice-based research network. Each PCP consecutively asked 40 patients if they ...
Source: Journal of Sleep Research - Category: Sleep Medicine Authors: Tags: J Sleep Res Source Type: research
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