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A mixed methods examination of insomnia in early psychosis
[Thesis]. Manchester, UK: The University of Manchester; 2017.
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Abstract
The available evidence suggests insomnia is common in individuals who experience psychosis. Poor sleep within this population has been associated with numerous detriments to mental health and well-being. Nevertheless, the majority of work to date has focused on chronic presentations, with few studies investigating the role of insomnia in recently onset psychosis. Understanding and treating psychosis following the first presentation is important to promote recovery and prevent the development of long-term illness. This work therefore aimed to utilise mixed methods to comprehensively investigate insomnia in early psychosis. It is presented in a series of five research papers, supplemented by additional chapters to provide an introduction, additional methodological details and general discussion. Paper one presents a systematic review, which aimed to synthesise the relevant literature with regards to the nature and correlates of insomnia in early psychosis. Paper two utilised qualitative methods aiming to understand the experience of insomnia, its impacts and experiences of help-seeking in early psychosis. Paper three aimed to investigate the nature of insomnia symptoms in first episode psychosis, compared to a healthy control group, using actigraphy and sleep diary measurement over a 14-day period. Paper four aimed to investigate how poor sleep was associated with next-day mental health and functioning, presenting data from an electronic diary study conducted alongside the sleep profiling presented in paper three. Paper five aimed to assess the acceptability of a Brief Behavioural Treatment for Insomnia (BBTI) delivered to a first episode psychosis group. Findings across studies indicated insomnia to have a wide range of detrimental outcomes, indicating the treatment of insomnia may be an important target for relevant mental health services.