Therapist training in treating sleep problems: A survey study of clinical practice

Abstract

Objectives Mental health care clinicians' training in treating sleep problems was investigated. We examined clinicians' (1) prior training in providing treatment for sleep problems, (2) interest in receiving training in treatment for sleep problems, and (3) perceptions of the importance of treating sleep problems and interest in incorporating sleep treatments into their practices. Methods An online survey was completed by 137 clinicians. Results The majority of clinicians (61.31%) reported receiving prior training in treating sleep problems, most commonly in the form of a workshop and after receiving a graduate degree. Most clinicians reported interest in receiving further training in treating sleep problems. Clinicians reported that the majority (66.67%) of their clients experience sleep problems, yet reported that they address sleep with fewer than half of clients. Addressing sleep in treatment was rated as “somewhat” to “very” important and most clinicians indicated further interest in receiving training in treating sleep. Conclusions Mental health care clinicians receive limited training in treating sleep problems. As clinicians are interested in gaining further training to address sleep concerns within their clinical practice, training programs and continuing education programs should consider increasing the amount of programming in sleep treatment and assessment.

Prevalence of sleep disorder diagnoses and sleep medication prescriptions in individuals with ADHD across the lifespan: a Swedish nationwide register-based study

“…The high rates of ‘unspecified’ diagnoses may reflect other sleep disorders (such as RLS or sleep-wake schedule disorders (ie, circadian rhythm disorders)) that can easily be missed by practitioners or misdiagnosed as more general sleep disorders, such as insomnia or unspecified sleep disorders 20. Practitioners who are not sleep experts may have inadequate knowledge or tools to assess specific sleep disorders, which is in line with previous reports of poor coverage of sleep disorders in clinical psychology programmes and in medical school education 19–21. Misdiagnosis of sleep disorders can be very serious, as treatments to alleviate sleep problems are then ineffective and can potentially be harmful for patients 22…”

“…The markedly lower administrative prevalence of diagnosed sleep disorders in our study could be an indication that sleep disorders are being underdiagnosed in individuals with ADHD, in contrast to the much higher rates of medication prescriptions for sleep problems. Indeed, underdiagnosis of sleep disorders is a common problem in clinical practice in general,17 18 possibly because of limited coverage of sleep disorders in clinical psychology programmes and in medical school 19–21…”

“…This large discrepancy could be an indication that clinicians, on average, are not conducting evidence-based assessments of sleep disorders in individuals with ADHD. This could reflect a more general pattern where sleep disorders are often underinvestigated or completely ignored,17 18 which may be driven by the relatively poor coverage of sleep in medical school education and in clinical psychology programmes 19–21. It is possible that sleep problems are seen as symptoms of ADHD or related problems, or are being overshadowed by ADHD, and therefore do not result in a separate sleep diagnosis.…”

“…Indeed, underdiagnosis of sleep disorders is a common problem in clinical practice in general, 17 18 possibly because of limited coverage of sleep disorders in clinical psychology programmes and in medical school. 19–21 …”

“…This could reflect a more general pattern where sleep disorders are often underinvestigated or completely ignored, 17 18 which may be driven by the relatively poor coverage of sleep in medical school education and in clinical psychology programmes. 19–21 It is possible that sleep problems are seen as symptoms of ADHD or related problems, or are being overshadowed by ADHD, and therefore do not result in a separate sleep diagnosis. Our findings highlight the need for sleep problems to be rigorously assessed and appropriately diagnosed in both men and women with ADHD, throughout the lifespan.…”