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Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
}
TY - JOUR
T1 - The effects of improving sleep on mental health (OASIS)
T2 - a randomised controlled trial with mediation analysis
AU - Freeman, Daniel
AU - Sheaves, Bryony
AU - Goodwin, Guy M
AU - Yu, Ly-Mee
AU - Nickless, Alecia
AU - Harrison, Paul J
AU - Emsley, Richard
AU - Luik, Annemarie I
AU - Foster, Russell G
AU - Wadekar, Vanashree
AU - Hinds, Christopher
AU - Gumley, Andrew
AU - Jones, Ray
AU - Lightman, Stafford
AU - Jones, Steven
AU - Bentall, Richard
AU - Kinderman, Peter
AU - Rowse, Georgina
AU - Brugha, Traolach
AU - Blagrove, Mark
AU - Gregory, Alice M
AU - Fleming, Leanne
AU - Walklet, Elaine
AU - Glazebrook, Cris
AU - Davies, E Bethan
AU - Hollis, Chris
AU - Haddock, Gillian
AU - John, Bev
AU - Coulson, Mark
AU - Fowler, David
AU - Pugh, Katherine
AU - Cape, John
AU - Moseley, Peter
AU - Brown, Gary
AU - Hughes, Claire
AU - Obonsawin, Marc
AU - Coker, Sian
AU - Watkins, Edward
AU - Schwannauer, Matthias
AU - MacMahon, Kenneth
AU - Siriwardena, A Niroshan
AU - Espie, Colin A
PY - 2017/10
Y1 - 2017/10
N2 - Background Sleep difficulties might be a contributory causal factor in the occurrence of mental health problems. If this is true, improving sleep should benefit psychological health. We aimed to determine whether treating insomnia leads to a reduction in paranoia and hallucinations. Methods We did this single-blind, randomised controlled trial (OASIS) at 26 UK universities. University students with insomnia were randomly assigned (1:1) with simple randomisation to receive digital cognitive behavioural therapy (CBT) for insomnia or usual care, and the research team were masked to the treatment. Online assessments took place at weeks 0, 3, 10 (end of therapy), and 22. The primary outcome measures were for insomnia, paranoia, and hallucinatory experiences. We did intention-to-treat analyses. The trial is registered with the ISRCTN registry, number ISRCTN61272251. Findings Between March 5, 2015, and Feb 17, 2016, we randomly assigned 3755 participants to receive digital CBT for insomnia (n=1891) or usual practice (n=1864). Compared with usual practice, the sleep intervention at 10 weeks reduced insomnia (adjusted difference 4·78, 95% CI 4·29 to 5·26, Cohen's d=1·11; p<0·0001), paranoia (−2·22, −2·98 to −1·45, Cohen's d=0·19; p<0·0001), and hallucinations (−1·58, −1·98 to −1·18, Cohen's d=0·24; p<0·0001). Insomnia was a mediator of change in paranoia and hallucinations. No adverse events were reported. Interpretation To our knowledge, this is the largest randomised controlled trial of a psychological intervention for a mental health problem. It provides strong evidence that insomnia is a causal factor in the occurrence of psychotic experiences and other mental health problems. Whether the results generalise beyond a student population requires testing. The treatment of disrupted sleep might require a higher priority in mental health provision. Funding Wellcome Trust.
AB - Background Sleep difficulties might be a contributory causal factor in the occurrence of mental health problems. If this is true, improving sleep should benefit psychological health. We aimed to determine whether treating insomnia leads to a reduction in paranoia and hallucinations. Methods We did this single-blind, randomised controlled trial (OASIS) at 26 UK universities. University students with insomnia were randomly assigned (1:1) with simple randomisation to receive digital cognitive behavioural therapy (CBT) for insomnia or usual care, and the research team were masked to the treatment. Online assessments took place at weeks 0, 3, 10 (end of therapy), and 22. The primary outcome measures were for insomnia, paranoia, and hallucinatory experiences. We did intention-to-treat analyses. The trial is registered with the ISRCTN registry, number ISRCTN61272251. Findings Between March 5, 2015, and Feb 17, 2016, we randomly assigned 3755 participants to receive digital CBT for insomnia (n=1891) or usual practice (n=1864). Compared with usual practice, the sleep intervention at 10 weeks reduced insomnia (adjusted difference 4·78, 95% CI 4·29 to 5·26, Cohen's d=1·11; p<0·0001), paranoia (−2·22, −2·98 to −1·45, Cohen's d=0·19; p<0·0001), and hallucinations (−1·58, −1·98 to −1·18, Cohen's d=0·24; p<0·0001). Insomnia was a mediator of change in paranoia and hallucinations. No adverse events were reported. Interpretation To our knowledge, this is the largest randomised controlled trial of a psychological intervention for a mental health problem. It provides strong evidence that insomnia is a causal factor in the occurrence of psychotic experiences and other mental health problems. Whether the results generalise beyond a student population requires testing. The treatment of disrupted sleep might require a higher priority in mental health provision. Funding Wellcome Trust.
U2 - 10.1016/S2215-0366(17)30328-0
DO - 10.1016/S2215-0366(17)30328-0
M3 - Journal article
VL - 4
SP - 749
EP - 758
JO - Lancet Psychiatry
JF - Lancet Psychiatry
SN - 2215-0366
IS - 10
ER -