Institute of Brain Behaviour and Mental Health, University of Manchester, Manchester, Oxford Road, M13 9PL England, United Kingdom.
School of Psychological Sciences, University of Manchester, Manchester, Oxford Road, M13 9PL England, United Kingdom.
Sleep Med Rev. 2015 Dec;24:13-27. doi: 10.1016/j.smrv.2014.12.002. Epub 2014 Dec 13.
Prisoners have many potential risk factors for insomnia including mental ill health and substance misuse. However, literature on prevalence, associated factors and management of insomnia in prison has yet to be systematically examined in this group. The paper objective was to synthesise and appraise the research that examines insomnia in a prison environment. An integrative literature review using thematic analysis was conducted to critically reflect on the current evidence base and outline a prospective research agenda. From the original 384 sourced papers, 33 met the inclusion criteria and were subsequently included for review. Definitions of insomnia and assessment tools used in studies varied considerably making the overall validity of findings uncertain. Notably, no studies used a recommended measure to assess insomnia disorder (ID). Thematic analysis yielded five themes: 1) the varied prevalence of insomnia; 2) the comorbidity of insomnia, psychiatric disorder and substance misuse; 3) the negative influence of prison-related situational and environmental factors on insomnia; 4) the role of hypnotic medication, and, 5) preliminary indications that non-pharmacological treatment can improve sleep. The methodological heterogeneity and variable quality across studies in the assessment of insomnia means conclusive data on prevalence, associated factors and management is lacking. Nonetheless, sleep problems are common and impairing in prison, are linked to comorbid conditions and negatively influenced by the prison environment, which routinely provides limited scope for effective management. Future research in prison populations is needed to reliably identify insomnia prevalence and determine how it can be managed effectively.
囚犯存在许多潜在的失眠风险因素，包括心理健康问题和药物滥用。然而，关于监狱环境中失眠的患病率、相关因素和管理的文献尚未在该群体中得到系统研究。本文的目的是综合和评估研究监狱环境中失眠的研究。使用主题分析的综合文献综述批判性地反思了当前的证据基础，并概述了未来的研究议程。从最初的 384 篇来源论文中，有 33 篇符合纳入标准，并随后纳入了综述。研究中使用的失眠定义和评估工具差异很大，使得研究结果的整体有效性不确定。值得注意的是，没有研究使用推荐的测量工具来评估失眠障碍（ID）。主题分析产生了五个主题：1）失眠的患病率差异很大；2）失眠、精神障碍和药物滥用共病；3）与监狱相关的情境和环境因素对失眠的负面影响；4）催眠药物的作用，以及 5）非药物治疗可以改善睡眠的初步迹象。评估失眠时研究在方法学上的异质性和可变的质量意味着在患病率、相关因素和管理方面缺乏确凿的数据。尽管如此，睡眠问题在监狱中很常见且具有破坏性，与共病有关，并受到监狱环境的负面影响，监狱环境通常为有效管理提供的范围有限。需要在监狱人群中进行未来的研究，以可靠地确定失眠的患病率，并确定如何有效地进行管理。
