title: The prevalence and management of poor sleep quality in a secondary care mental health population.
abstract: OBJECTIVE
  Poor sleep quality, particularly insomnia, has been identified as a frequent problem among individuals with mental health difficulties. Comorbid sleep difficulties adversely affect quality of life and functioning, and have been associated with the causation and maintenance of a number of psychiatric disorders, as well as increasing the risk of relapse. The study objectives were to ascertain clinician knowledge related to insomnia, investigate sleep quality among service users in a community mental health setting in the UK, and evaluate service provision of evidence-based interventions for sleep difficulties.
  
  
  METHODS
  A cross-sectional design was used. Nineteen clinicians completed a questionnaire on their clinical practice. Seventy-three service users completed the Pittsburgh Sleep Quality Index and provided self-report data on interventions received and associated satisfaction.
  
  
  RESULTS
  Clinical staff demonstrated deficits in knowledge of insomnia symptomatology. Sixty-four percent (95% CI 54% to 74%) of service users were identified as poor sleepers on the PSQI. Sixty-one percent of poor sleepers had not been offered support for sleep difficulties. The most common support received was prescribed psychotropic medication (32%). Cognitive behavioral therapy was the intervention rated as most helpful but was only received by 6%.
  
  
  CONCLUSIONS
  This study highlights inadequaciesin providing evidence-based interventions for sleep difficulties. Key recommendations include training clinicians in the identification of sleep difficulties and provision of evidence-based interventions, provision of cost-effective transdiagnostic group interventions, and formalizing assessment and treatment pathways for service users with sleep difficulties.
authors.affiliation: School of Psychology, University of Surrey, Surrey, UK: Surrey & Borders Partnership Mental Health NHS Foundation Trust, Surrey, UK.
authors.forename: Michelle
authors.initials: M
authors.lastname: O'Sullivan
authors.affiliation: School of Psychology, University of Surrey, Surrey, UK: Surrey & Borders Partnership Mental Health NHS Foundation Trust, Surrey, UK.
authors.forename: Masuma
authors.initials: M
authors.lastname: Rahim
authors.affiliation: South-West London & St George's Mental Health NHS Trust, London, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Hall
mesh_terms: D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D063127:Secondary Health Care; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
keywords: CBT; cognitive-behavioural therapy; comorbid insomnia; insomnia; mental health; prevalence; sleep disorders; sleep disturbance; sleep quality