Early detection and treatment of sleep disorders in psychiatric patients

Background: Sleep is important for physical health, cognitive functioning and quality of life. Additionally, it has become clear that proper sleep is also crucial for mental health and recovery of psychiatric disorders. Therefore, early detection and adequate treatment of sleep disorders in psychiatric populations may be very relevant to improve the care of these patients. Unfortunately in psychiatric care sleep disorders are often overlooked and thus, treated late or not at all. In order to increase knowledge and improve care of patients with comorbid mental and sleep disorders in the proposed wait-list control study we will investigate the clinical relevance of early identification and treatment of sleep disorders in psychiatric patients. The two aims of the proposed project are 1) to determine the prevalence of sleep disorders in a psychiatric patient population, and 2) to investigate the contribution of early identification and adequate treatment of sleep disorders in people suffering from mental disorders.

Study design: The prevalence of sleep disorders will be assessed in the GGZ Drenthe population by means of a screening questionnaire (HSDQ). Those patients scoring above the cut-off criteria for at least one of the HSDQ subscales will be invited for diagnosis and treatment of their sleep disorder. The effect of sleep disorder treatment in addition to psychiatric treatment as usual (TAU) will be assessed on general and specific mental well-being and quality of life, using a randomized wait-list control design. To ensure a good fit with this complex psychiatric patient population adjustments will be made to standard sleep interventions.

Study population: Patients (≥18 yrs) newly referred to GGZ Drenthe during the 3-year inclusion period who are capable of filling out questionnaires in the Dutch language are invited to participate in this study. Those patients screening positive for a sleep disorder will be invited to participate in the intervention part of the study.

Generally, we expect to observe a higher prevalence of sleep disorders in the psychiatric patient population than has previously been reported for the general population.

Concerning the psychiatry-tailored sleep interventions, we expect that effective treatment of sleep disorders will improve mental well-being and quality of life in a large group of our patients. Specifically we hypothesize that:
o The effect of sleep intervention(s) added to TAU on psychiatric symptoms will exceed those of TAU alone.
o Added sleep intervention(s) will improve quality of life relative to TAU.
o Early treatment of sleep disorders, within 6 months, will improve psychiatric symptoms and quality of life to a larger extent than sleep disorder treatment initiated after 6 months.

- T0= Baseline
- T1= 6 months
- T2= 12 months

Sleep disorder treatment