How Do Internal Mechanisms Shape the Trauma-Sleep Relationship?

  • Research type

    Research Study

  • Full title

    Investigating how internal cognitive and emotional mechanisms shape the trauma-sleep relationship in psychiatric inpatients.

  • IRAS ID

    362503

  • Contact name

    Jane Ireland

  • Contact email

    JLIreland1@lancashire.ac.uk

  • Sponsor organisation

    University of Lancashire

  • Duration of Study in the UK

    1 years, 6 months, 1 days

  • Research summary

    Associations between psychological distress and sleep are well established, with internal experiences often cited as reasons for nighttime awakenings (Goelema et al., 2018). However, few studies have explored the mechanisms that underpin this relationship, particularly among psychiatric populations. This study, therefore, aims to explore internal mechanisms, such as cognitions and emotions of psychosis inpatients, to better understand the trauma-sleep relationship.

    Patients will be made up of male inpatients with a history of psychosis, based at a forensic mental health hospital (Ashworth High Secure Hospital) in the United Kingdom. Findings will be compared to a non-clinical sample gathered from the community using Prolific. Here, measures of psychosis proneness will be used to allow accurate comparisons.

    Participants will be split by chronotype, using the Morning-Eveningness questionnaire, as this has been highlighted as a risk factor for poor sleep. Questionnaires will be used to gather data, and these will focus on aspects such as fear of sleep, pre-sleep arousal, nighttime cognitions and rumination, nightmare content, nighttime emotions, trauma experiences, intrusion symptoms, and sleep quality. Regression analyses and linear mixed models will then be used to answer the question ‘How do internal mechanisms shape the trauma-sleep relationship?’

    It is hypothesised that:
    - Psychosis inpatients will present with greater trauma-related sleep disturbances and intrusion symptoms than the community samples.
    - Evening chronotype and psychosis proneness will be associated with increased nightmare frequency, pre-sleep arousal, and fear of sleep.

    There may be some theoretical implications, with findings possibly reframing the trauma-sleep relationship by suggesting that complex internal mechanisms (such as fear of sleep and pre-sleep arousal) mediate this relationship. The thesis may also highlight some vulnerability factors, such as evening chronotype, which may interact with trauma, shaping sleep outcomes. Identifying these may, in turn, help clinicians identify risk factors and provide early intervention.

  • REC name

    London - Brighton & Sussex Research Ethics Committee

  • REC reference

    25/LO/0883

  • Date of REC Opinion

    17 Dec 2025

  • REC opinion

    Unfavourable Opinion