Imperial College London
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Dr Lindsay H. Dewa

Faculty of Medicine, School of Public Health

Advanced Research Fellow
 
 
 
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Contact

 

+44 (0)20 7594 0815l.dewa

 
 
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Location

 

609School of Public HealthWhite City Campus

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Summary

 

Publications

Citation

BibTex format

@article{Dewa:2024:sleepadvances/zpae003,
author = {Dewa, L and Thibaut, B and Pattison, N and Campbell, S and Woodcock, T and Aylin, P and Archer, S},
doi = {sleepadvances/zpae003},
journal = {Sleep Advances},
title = {Treating insomnia in people who are incarcerated: a feasibility study of a multi-component treatment pathway},
url = {http://dx.doi.org/10.1093/sleepadvances/zpae003},
year = {2024}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Around 60% of people who are incarcerated have insomnia; 6-10 times more prevalent than the general population. Yet, there is no standardised, evidence-based approach to insomnia treatment in prison. We assessed the feasibility of a treatment pathway for insomnia in a high-secure prison to inform a future randomised controlled trial (RCT) and initial efficacy data for sleep and mental health outcomes. We used a within-subjects pre-post design. The stepped-care pathway included: self-management with peer support, environmental aids, and cognitive behavioural therapy for insomnia (CBTi). Assessment measures for insomnia, wellbeing, mood, anxiety, suicidality, overall health, sleepiness, fatigue, and cognitive functioning were administered at baseline and pathway exit. Feasibility criteria included eligibility to participate, CBTi uptake and assessment completion. Forty-two adult males who are incarcerated were approached of which 95.2% were eligible. Of those deemed eligible, most participated (36/40, 90.0%). Most who completed baseline completed post-assessments (28/36, 77.8%) and of these, most showed improvements in their subjective sleep (27/28, 96.4%). Large reductions were found from pre- to post-treatment in insomnia severity (d=-1.81, 95% CIs 8.3 to 12.9) and 57.0% reported no clinically significant insomnia symptoms at post-assessment. There was no overall change in actigraphy-measured sleep. Large treatment benefits were found for depression, anxiety, wellbeing, and cognitive functioning, with a medium benefit on suicidal ideation. The treatment pathway for insomnia in prison was feasible and may be an effective treatment for insomnia in people who are incarcerated, with additional promising benefits for mental health. A pragmatic RCT across different prison populations is warranted.
AU  - Dewa,L
AU  - Thibaut,B
AU  - Pattison,N
AU  - Campbell,S
AU  - Woodcock,T
AU  - Aylin,P
AU  - Archer,S
DO  - sleepadvances/zpae003
PY  - 2024///
SN  - 2632-5012
TI  - Treating insomnia in people who are incarcerated: a feasibility study of a multi-component treatment pathway
T2  - Sleep Advances
UR  - http://dx.doi.org/10.1093/sleepadvances/zpae003
UR  - http://hdl.handle.net/10044/1/109253
ER  -
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