Acute Psychological Sleep Stabilisation for Patients Hospitalised With Depression

N/AEnrolling By InvitationNCT06145555

Karolinska Institutet100 enrolled

Overview

Disturbed sleep occurs in almost all patients in psychiatric inpatient care, and although it is well known that comorbid sleep disorders in depression often persist after treatment of depression and also increase the risk of new depressive episodes, the availability of effective, evidence-based treatments for sleep disorders in hospitalised patients is very limited. The overall goal of the current project is to translate, adapt and evaluate an acute psychological sleep treatment based on cognitive behavioural therapy for insomnia (CBT-I) for patients hospitalized with depression and comorbid sleep problems in the specialized psychiatric inpatient care in the Stockholm Region. The main hypothesis for the study is that acute psychological sleep stabilization (APS) reduces self-reported sleep complains compared to care as usual reinforced with sleep hygiene advice, and secondary hypotheses are that APS also leads to reduced depressive symptoms and earlier discharge. The project includes a pilot study, which will be followed by a randomized, controlled trial of APS compared to care as usual with structured sleep hygiene (minimal active control) and treatment effect is evaluated every three days during the hospital stay and 1,2,4 and 12 weeks after randomization. APS will be performed by existing staff in the department with the support of a psychologist.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

100

Conditions

Insomnia

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Admitted to the psychiatric inpatient care (Psykiatri Sydväst) * Depressive symptoms / confirmed depressive episode (uni- or bipolar) * Reports or is observed to have sleep problems in the form of insomnia, hypersomnia or delayed circadian phase * Knowledge of Swedish or English that is deemed sufficient to undergo the treatment * Consent to be included in the study and is judged to have understood what the study entails (care according to the Compulsory Psychiatric Care Act is not in itself an exclusion criterion) Exclusion Criteria: * Dementia * Intellectual disability * Severe somatic comorbidity with life expectancy \<6 months * Ongoing mania / mixed-state * Complex problems that make APS impossible or inappropriate * Expected discharge within 3 days

Outcomes

Primary Outcomes

Insomnia Severity Index

A self-report measure of insomnia symptoms. 7-item, self-rated questionnaire measuring insomnia severity. Total score 0-28, higher score indicates more severe sleep problems.

Time frame: 2 weeks post randomization (secondary timepoints include day 4, 7, 10 and week 4 and 12)

Secondary Outcomes

Patient Health Questionnaire (PHQ-9)

Self-reported depressive symptoms. PHQ-9 is a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression. Total score 0-27, higher score indicates more severe depressive symptoms.

Time frame: Day 4, 7, 10 14 and week 4 and 12 post randomisation

Generalised Anxiety Disorder 7-item scale (GAD-7)

Self-reported anxiety symptoms. A seven-item instrument that is used to measure or assess the severity of generalised anxiety disorder/symptoms. Total score 0-27. Higher scores indicative of more severe problem.

Time frame: Day 4, 7, 10 14 and week 4 and 12 post randomisation

European Quality of Life 5 Dimensions scale (EQ-5D)

Self-reported quality of life. An instrument which evaluates the generic quality of life developed in Europe and widely used. The scale comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression.

Time frame: Week 2, 4 and 12 post randomisation