Impact of sleep disturbance on patients in treatment for mental disorders

Kallestad, Håvard; Hansen, Bjarne; Langsrud, Knut; Ruud, Torleif; Morken, Gunnar; Stiles, Tore C.; Gråwe, Rolf W.

doi:10.1186/1471-244x-12-179

Cited by 32 publications

(41 citation statements)

References 43 publications

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“…Previous research on sleep disturbance has indicated that specifically targeted sleep interventions are a pre‐requisite in order to significantly improve insomnia (Kallestad et al ., ). Our results, however, show that the patients with pre‐treatment sleep disturbance had a significant reduction in sleep problems from pre‐treatment to post‐treatment, and that these improvements were maintained at follow‐up.…”

Section: Discussionmentioning

confidence: 97%

“…Despite these findings, little is known about whether sleep disturbances influence treatment outcome when the patients receive adequate psychological treatment for their OCD-problems, or if comorbid sleep disturbances are affected when the OCD is effectively treated. Although studies indicate that secondary sleep disturbances are improved when the primary disorder is treated (Harvey, 2001), research also suggest that sleep disturbances should be specifically targeted during treatment in order to be successfully treated (Kallestad, Hansen, Langsrud et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Sleep disturbances in treatment‐seeking OCD‐patients: Changes after concentrated exposure treatment

Nordahl

Havnen

Hansen

et al. 2017

Scandinavian J Psychology

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Research indicates that patients with Obsessive Compulsive Disorder (OCD) frequently suffer from comorbid sleep difficulties, and that these difficulties often are not clinically recognized and diagnosed. There has been limited research investigating if comorbid sleep difficulties impair treatment outcome for OCD and if the sleep difficulties change following OCD-treatment. Thirty-six patients with obsessive compulsive disorder underwent concentrated exposure treatment delivered in a group over four consecutive days and were assessed with measures of OCD, depressive symptoms and sleep disturbance at three different time points (pre, post and 6 months follow-up). The sample was characterized by a high degree of comorbidity with other psychiatric disorders. At pre-treatment nearly 70% of the patients reported sleep difficulties indicative of primary insomnia. The results showed that patients had large reductions of OCD-symptoms as well as significant improvements in sleep disturbance assessed after treatment, and that these improvements were maintained at follow-up. Sleep disturbance did not impair treatment outcome, on the contrary patients with higher degree of sleep disturbance at pre-treatment had better outcome on OCD-symptoms after treatment. The results indicated that the majority of the OCD sample suffered from sleep disturbances and that these sleep disturbances were significantly reduced following adequate treatment of OCD without specific sleep interventions. However, a proportion of the patients suffered from residual symptoms of insomnia after treatment.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Sleep disturbances in treatment‐seeking OCD‐patients: Changes after concentrated exposure treatment

Nordahl

Havnen

Hansen

et al. 2017

Scandinavian J Psychology

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“…In general, a good sleep may be considered as a strong predictor of a good health,6,7 and conversely, a disturbed and/or interrupted sleep would be accompanied by many alterations in all aspects of life, in both genders and at all ages 8,9. In fact, sleep plays a key role for daytime functioning and neurocognitive performance in childhood and adolescence,10 probably promoting and/or influencing the neural plasticity process and enhancing memory consolidation during life 11.…”

Section: Introductionmentioning

confidence: 99%

Executive dysfunction in children affected by obstructive sleep apnea syndrome: an observational study

Esposito¹,

Antinolfi²,

Gallai³

et al. 2013

NDT

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IntroductionThe role of sleep in cognitive processes can be considered clear and well established. Different reports have disclosed the association between sleep and cognition in adults and in children, as well as the impact of disturbed sleep on various aspects of neuropsychological functioning and behavior in children and adolescents. Behavioral and cognitive dysfunctions can also be considered as related to alterations in the executive functions (EF) system. In particular, the EF concept refers to self-regulatory cognitive processes that are associated with monitoring and controlling both thought and goal directed behaviors. The aim of the present study is to assess the impact of the obstructive sleep apnea syndrome (OSAS) on EF in a large sample of school aged children.Materials and methodsThe study population comprised 79 children (51 males and 28 females) aged 7–12 years (mean 9.14 ± 2.36 years) with OSAS and 92 healthy children (63 males and 29 females, mean age 9.08 ± 2.44 years). To identify the severity of OSAS, an overnight respiratory evaluation was performed. All subjects filled out the Italian version of the Modified Card Sorting Test to screen EFs. Moreover, to check the degree of subjective perceived daytime sleepiness, all subjects were administered the Pediatric Daytime Sleepiness Scale (PDSS).ResultsNo significant differences between the two study groups were found for age (P = 0.871), gender (P = 0.704), z-score of body mass index (P = 0.656), total intelligence quotient (P = 0.358), and PDSS scores (P = 0.232). The OSAS children showed a significantly higher rate of total errors (P < 0.001), perseverative errors (P < 0.001), nonperseverative errors (P < 0.001), percentage of total errors (P < 0.001), percentage of perseverative errors (P < 0.001), and percentage of nonperseverative errors (P < 0.001). On the other hand, OSAS children showed a significant reduction in the number of completed categories (P = 0.036), total correct sorts (P = 0.001), and categorizing efficiency (P < 0.001). The Pearson’s correlation analysis revealed a significant positive relationship between all error parameters and apnea-hypopnea index, oxygen desaturation index, and percentage of mean desaturation of O2 with a specular negative relationship between the error parameters and the mean oxygen saturation values, such as a significant negative relationship between apnea-hypopnea index, oxygen desaturation index, percent of mean desaturation of O2, and the number of completed categories.ConclusionOur study identified differences in the executive functioning of children affected by OSAS and is the first to identify a correlation between alteration in respiratory nocturnal parameters and EF that has not yet been reported in developmental age. These findings can be considered as the strength and novelty of the present report in a large pediatric population.

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“…Evidence from our research demonstrates that day-to-day variability in sleep-wake cycles is associated with longer duration of acute psychiatric admissions and frequency of aggression or violent incidents [6,7]. Lastly, sleep problems are often the last symptoms to resolve during recovery from an acute episode of a mood or psychotic disorder [8,9]. Overall, experimental and clinical research emphasize the reciprocal relationship between sleep-wake disruptions and mental disorders showing that they perpetuate and exacerbate each other and that improved sleep is associated with improvements in mental state [10][11][12][13].…”

Section: Introductionmentioning

confidence: 84%

A pragmatic effectiveness randomized controlled trial of duration of psychiatric hospitalization in a trans-diagnostic sample of patients with acute mental illness admitted to a ward with either blue depleted evening lighting or normal lighting conditions

Scott¹,

Langsrud

Kjørstad³

et al. 2019

Preprint

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Introduction There is increasing recognition of the need to stabilize sleep-wake cycles in individuals with major mental disorders. As such, clinicians and researchers advocate for the use of interventions targeted at sleep and circadian dysrhythmias as an adjunct to the standard treatments offered for acute illness episodes of a broad range of diagnoses. To determine the trans-diagnostic generalizability of chronotherapy, we explore the benefits of admitting individuals with an acute illness episode to a psychiatric inpatient unit where changes in light exposure are integrated into the therapeutic environment. Methods A two-arm pragmatic effectiveness randomized controlled treatment trial, where individuals admitted for acute inpatient psychiatric care will be allocated to a ward with blue depleted evening light or to a ward with the same layout and facilities but lacking the new lighting technology. The trial will test whether the experimental lighting conditions offer any additional benefits beyond those associated with usual treatment in an acute psychiatric inpatient unit. The main objectives are to examine any differences between groups in the mean duration of hospitalization in days. Additional analyses will compare group differences in symptoms, functioning, medication usage, and side-effects and whether length of stay is associated with stability of sleep-wake cycles and circadian rhythms. Ancillary investigations will determine any benefits according to diagnostic subgroups and potential drawbacks such as any adverse effects on the well-being of professionals working across both wards. Discussion This unit offers a unique opportunity to explore how exposure to different lighting conditions may modify sleep-wake cycles and how any changes in sleep-wake cycle may impact on the clinical and functional outcomes of individuals experiencing an acute episode of a severe mental disorder that requires inpatient care. The findings could influence the future design of hospital units offering care to patients with mental or physical disorders. Trial registration Clinicaltrials.gov NCT03788993, retrospectively registered Dec 28th 2018. https://clinicaltrials.gov/ct2/show/NCT03788993.

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Impact of sleep disturbance on patients in treatment for mental disorders

Cited by 32 publications

References 43 publications

Sleep disturbances in treatment‐seeking OCD‐patients: Changes after concentrated exposure treatment

Sleep disturbances in treatment‐seeking OCD‐patients: Changes after concentrated exposure treatment

Executive dysfunction in children affected by obstructive sleep apnea syndrome: an observational study

A pragmatic effectiveness randomized controlled trial of duration of psychiatric hospitalization in a trans-diagnostic sample of patients with acute mental illness admitted to a ward with either blue depleted evening lighting or normal lighting conditions

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