Prevalence, associated factors and management of insomnia in prison populations: An integrative review

Dewa, Lindsay H.; Kyle, Simon D.; Hassan, Lamiece; Shaw, Jenny; Senior, Jane

doi:10.1016/j.smrv.2014.12.002

Cited by 35 publications

(49 citation statements)

References 69 publications

(130 reference statements)

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“…Ascertaining a precise prevalence benchmark of insomnia was difficult due to reported wide prevalence (11.8% and 81.0%) and variation in insomnia definitions and methodologies used across previous studies [25]. Therefore, for the purpose of estimating sample size, we assumed the prevalence rate of insomnia to be 50% (the value that would produce the highest possible sample size).…”

Section: Methodsmentioning

confidence: 99%

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Trouble sleeping inside: a cross-sectional study of the prevalence and associated risk factors of insomnia in adult prison populations in England

et al. 2017

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ObjectiveTo investigate the prevalence of insomnia and identify associated demographic, clinical and forensic risk factors in adult prisoners in England.MethodsA cross-sectional study of 237 prisoners aged 18–72 years, across two male prisons and one female prison in North England. We used the Sleep Condition Indicator to measure probable DSM-V insomnia disorder (ID) and the Pittsburgh Sleep Quality Index to examine sleep quality. Multiple demographic, sleep, clinical and forensic self-reported measures were recorded to identify any associations with insomnia.ResultsOverall, the prevalence of possible DSM-V ID was 61.6% (95% CI, 55.5%–67.8%). Subjective poor sleep quality was reported by 88.2% (95% CI, 84.1%–92.3%). Seven in ten (70.6%) female prisoners had possible DSM-V ID (95% CI, 64.8%–76.4%). Multivariable logistic regression analysis, adjusting for gender and age, indicated odds of having possible ID in prison were increased for the following factors: history of physical ill-health (OR = 3.62, 95% CI, 1.31–9.98); suicidality (OR = 2.79, 95% CI, 1.01.7.66), previously asked for help for insomnia (OR = 2.58, 95% CI, 1.21–5.47), depression (OR = 2.06, 95% CI 1.31–3.24), greater endorsement of dysfunctional beliefs about sleep (OR = 1.50, 95% CI, 1.21–1.87), poor sleep hygiene (OR = 1.11, 95% CI, 1.04–1.19), and problematic prison environment (eg, noise, light or temperature) (OR = 1.07, 95% CI, 1.02–1.12).ConclusionsFor the first time we have established the prevalence and associated factors of insomnia in a large sample of adult English prisoners. ID and poor sleep quality are common, especially in female prisoners. These findings emphasize/amplify the need for dedicated treatment pathways to improve screening, assessment and treatment of insomnia in prison.

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Section: Methodsmentioning

confidence: 99%

“…A recent systematic integrative review of both quantitative and qualitative studies into insomnia in prison reported on the findings from 33 papers [25]. Prevalence rates ranged from 11% to 81%; however studies were heterogeneous in terms of methodologies employed, sample size and jurisdiction.…”

Section: Introductionmentioning

confidence: 99%

Trouble sleeping inside: a cross-sectional study of the prevalence and associated risk factors of insomnia in adult prison populations in England

et al. 2017

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“…This included a systematic integrative review of published literature on insomnia in prison3; learning from a questionnaire survey and in-depth qualitative interviews with prison health and discipline staff and prisoners about the current treatment of insomnia (L Dewa, unpublished data, 2016)14; and a prevalence study of rates of short-term and long-term insomnia in a sample of English prisons 5. The preliminary pathway then went through an initial review by a convenience sample of academic sleep researchers, prison staff and prisoners.…”

Section: Methodsmentioning

confidence: 99%

“…The aim of this study was informed by previous research, which has found that insomnia is both highly prevalent and a source of dissatisfaction among people in prison 3 5 14 28. On the advice of prisoners and prison staff, rather than having a separate involvement group for people in prison, we chose to modify the Delphi design to incorporate prisoner perspectives as a complementary source of insight and expertise in designing the pathway, alongside those of professionals.…”

Section: Methodsmentioning

confidence: 99%

“…Around a third of the general population experience insomnia at some point in their lives2; however, recent figures show prisoners are at least twice as likely to have insomnia and the majority have poor sleep quality 3–5. This is problematic because insomnia has been shown to significantly contribute to poor cognitive functioning, depression, suicide, emotional dysregulation, aggression and lack of treatment engagement, all of which may affect the safe running of the prison, an individual’s rehabilitation and, ultimately, the likelihood of reoffending 6–9…”

Section: Introductionmentioning

confidence: 99%

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Design of a treatment pathway for insomnia in prison settings in England: a modified Delphi study

et al. 2018

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ObjectiveInsomnia is highly prevalent in prisoners and is a risk factor for poor mental well-being, depression, suicidality and aggression, all common concerns in this vulnerable population. Improving sleep management options in prison offers the potential to impact positively on a number of these common risk factors. The study aim was to design a treatment pathway for insomnia in prisons informed by stakeholders with professional or lived experience of insomnia and prison-based interventions.DesignA modified Delphi technique, adapted to the stakeholder (either receiving controlled feedback online or face to face on a series of statements), was used over three rounds to gain consensus on a final treatment pathway design.ParticipantsAcademic sleep researchers, prison staff and prisoners were invited to develop the treatment pathway.ResultsFifteen stakeholders took part in round 1 and thirteen in round 2. There were six statements of contention that comprised concerns over the inclusion of sleep observations, sleep restriction therapy and promethazine. Consensus was high (>80%). Thirteen stakeholders agreed the final pathway in round 3. The final treatment pathway comprised a standardised stepped-care approach for insomnia in prison populations. The pathway resulted in five main stages: (1) transition from community; (2) detection and assessment; (3) treatment for short-term insomnia; (4) treatment for long-term insomnia and (5) transition from prison to community or another establishment.ConclusionsThe treatment pathway is designed to promote early detection of insomnia, potentially reducing unnecessary prescriptions and medication trading, misuse and diversion in the prison setting. It should make a substantial difference in reducing the large number of sleep complaints and positively impact on prisoners, staff and the prison environment. Specifically, improving sleep should have a positive impact on prisoners’ mental and physical well-being and aid smooth running of the prison.

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Special Considerations: Institutional Aggression and Reciprocal Influences

Fins,

Stripling,

Dautovich

et al. 2024

SpringerBriefs in Psychology

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Prevalence, associated factors and management of insomnia in prison populations: An integrative review

Cited by 35 publications

References 69 publications

Trouble sleeping inside: a cross-sectional study of the prevalence and associated risk factors of insomnia in adult prison populations in England

Trouble sleeping inside: a cross-sectional study of the prevalence and associated risk factors of insomnia in adult prison populations in England

Design of a treatment pathway for insomnia in prison settings in England: a modified Delphi study

Special Considerations: Institutional Aggression and Reciprocal Influences

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