Berkshire Healthcare NHS Foundation Trust, Thatcham, UK.
Department of Psychiatry, University of Oxford, Oxford, UK.
J Sleep Res. 2024 Apr;33(2):e14056. doi: 10.1111/jsr.14056. Epub 2023 Oct 3.
Sleep problems are common for adolescents with psychiatric disorders, and sleep treatment may aid mental health recovery. Inpatient admissions are likely a particularly challenging time for sleep. Despite this little is known about the nature of sleep problems, and how sleep treatments could be optimised for this setting. This mixed-methods study set out to better understand sleep disturbances in adolescent inpatients. Study 1 examined the prevalence of Sleep Condition Indicator-assessed insomnia at admission and associations with psychiatric symptoms and admission length in 100 inpatients (aged 11-17 years) on one unit in Oxford. Data were gathered from admission routine measures and medical records. Associations were analysed using linear regressions. Half of the inpatients (n = 50) screened positive for insomnia at admission. Moderate-large significant associations were observed between more severe insomnia and more severe depression (β = -0.56), anxiety (β = -0.51), self-harm (β = -0.49), psychotic experiences (β = -0.32), and conduct problems (β = -0.30), but not admission length. Study 2 gained 12 clinicians' perspectives on sleep problems on the unit via a focus group and semi-structured interviews, analysed using thematic analysis. Ward staff observed insomnia and excessive daytime sleepiness in adolescent inpatients and a reciprocal relationship with mental health symptoms. Ward processes were barriers (e.g., night-time observations) and facilitators (e.g., regular routines) of sleep. Cognitive behavioural therapy for insomnia was not routinely offered but viewed as potentially helpful. Insomnia may be a common problem for adolescent inpatients, associated with greater psychopathology, but not admission length. The possible benefits of psychological sleep interventions for adolescents admitted to psychiatric units now require testing.
睡眠问题在患有精神疾病的青少年中很常见，睡眠治疗可能有助于心理健康的恢复。住院期间可能是睡眠特别困难的时期。尽管人们对睡眠问题的性质以及如何优化这种环境下的睡眠治疗知之甚少。这项混合方法研究旨在更好地了解青少年住院患者的睡眠障碍。研究 1 在牛津的一个病房中，对 100 名（年龄在 11-17 岁）住院青少年入院时的睡眠状况指标评估的失眠症患病率及其与精神症状和入院时间的关系进行了研究。数据来自入院常规测量和病历。使用线性回归分析关联。一半的住院患者（n=50）在入院时筛查出失眠症。在更严重的失眠症与更严重的抑郁症（β=-0.56）、焦虑症（β=-0.51）、自伤（β=-0.49）、精神病体验（β=-0.32）和行为问题（β=-0.30）之间观察到中度到显著的关联，但与入院时间无关。研究 2 通过焦点小组和半结构化访谈从该病房的 12 位临床医生那里获得了他们对睡眠问题的看法，使用主题分析进行分析。病房工作人员观察到青少年住院患者的失眠症和日间嗜睡，并观察到与心理健康症状的相互关系。病房流程是睡眠的障碍因素（例如，夜间观察）和促进因素（例如，定期作息）。失眠症认知行为疗法虽然没有常规提供，但被认为可能有帮助。失眠症可能是青少年住院患者的常见问题，与更多的精神病理学有关，但与入院时间无关。现在需要对针对精神病病房入院的青少年进行心理睡眠干预的可能益处进行测试。
