Implementation of Digital CBT for Insomnia in First Episode Psychosis
Research type
Research Study
Full title
Implementation of a Digital Cognitive Behavioural Therapy Intervention for Insomnia in First Episode Psychosis in the Context of Covid19: A Mixed Methods Study
IRAS ID
280858
Contact name
Andrew Gumley
Contact email
Sponsor organisation
NHS Greater Glasgow and Clyde
Clinicaltrials.gov Identifier
Duration of Study in the UK
0 years, 8 months, 0 days
Research summary
Summary of Research
‘Lockdown’ regulations due to Covid-19 negatively affect population mental health and sleep. They have a bigger impact on people who already have mental health difficulties, including psychosis. Insomnia is common in people with psychosis, including people experiencing a ‘first episode’ of psychosis. Increased insomnia is related to increased psychosis symptomatology. Worry also increases insomnia. Under Covid19 regulations, insomnia and worry may worsen and lead to increased psychosis.\n\nCognitive Behavioural Therapy is effective in reducing insomnia (CBTi) in people with or without psychosis. CBT for insomnia can be delivered digitally (dCBTi) and could be accessed remotely during lockdown.\n\nWe would like to know if dCBTi could work for people experiencing a first episode of psychosis (FEP) and insomnia, during lockdown. We will investigate how people use the dCBTi application. We will measure how symptoms of insomnia, psychosis, mood and worry change when using dCBTi and how they relate to one another. We want to know what people with FEP and keyworkers in FEP services think of the application. We will use this information to build a logic model to describe how dCBTi can be used in services.\n\nMethods\n\nKeyworkers working with people experiencing a FEP will screen for insomnia. Those with insomnia will be given information about the study. We will contact interested participants to seek consent. We will meet participants by videocall or in person to assess their sleep and measure psychosis, insomnia, mood, and Covid-19-related worry symptoms before we begin and after intervention.\n\nThe ’Sleepio’ intervention has 6 sessions, accessed on a smartphone or browser. We will record how people use this application.\n\nPeople with FEP and keyworkers will have the option of taking part in pre- and post-intervention interviews to tell us about their expectations and experiences of the application.
Summary of Results
We are grateful for service users and key workers who took part in this study. In this implementation study we sought to identify whether a digital intervention for insomnia (i.e. Sleepio) could be used in the context of an early intervention in psychosis service. The study took place as soon as possible after the pandemic. We found that clinicians were interested in the study, evidenced by the numbers of referrals. However, these referrals did not always translate into service users who were willing to take part in the study. Of participants who provided written informed consent, we found everyone enrolled in the initial Sleepio session and this was facilitated by the researchers. However, there was a drop-off after this point, and no participant completed all sessions. Despite this, we are grateful to participants who completed the research measures at the end of the study and this demonstrates their acceptability. Results suggest that in this client group, more support could be beneficial when accessing sleep interventions. We also spoke to several keyworkers about expectations, finding results about sleep interventions in general and digital interventions specifically. These findings will also help inform how sleep interventions could be implemented in an early intervention in psychosis service.REC name
West of Scotland REC 4
REC reference
21/WS/0010
Date of REC Opinion
24 Mar 2021
REC opinion
Further Information Favourable Opinion