Skip to main content
×
Home
    • Aa
    • Aa

Treating Sleep Problems in Patients with Schizophrenia

  • Felicity Waite (a1), Elissa Myers (a2), Allison G. Harvey (a3), Colin A. Espie (a4), Helen Startup (a5), Bryony Sheaves (a1) and Daniel Freeman (a1)...
Abstract

Background: Sleep disturbance is increasingly recognized as a major problem for patients with schizophrenia but it is rarely the direct focus of treatment. The main recommended treatment for insomnia is cognitive behavioural therapy, which we have been evaluating for patients with current delusions and hallucinations in the context of non-affective psychosis. Aims: In this article we describe the lessons we have learned about clinical presentations of sleep problems in schizophrenia and the adaptations to intervention that we recommend for patients with current delusions and hallucinations. Method: Twelve factors that may particularly contribute to sleep problems in schizophrenia are identified. These include delusions and hallucinations interfering with sleep, attempts to use sleep as an escape from voices, circadian rhythm disruption, insufficient daytime activity, and fear of the bed, based upon past adverse experiences. Specific adaptations for psychological treatment related to each factor are described. Conclusions: Our experience is that patients want help to improve their sleep; sleep problems in schizophrenia should be treated with evidence-based interventions, and that the interventions may have the added benefit of lessening the psychotic experiences. A treatment technique hierarchy is proposed for ease of translation to clinical practice.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Treating Sleep Problems in Patients with Schizophrenia
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Treating Sleep Problems in Patients with Schizophrenia
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Treating Sleep Problems in Patients with Schizophrenia
      Available formats
      ×
Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Reprint requests to Felicity Waite, Clinical Psychologist, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK. E-mail: felicity.waite@psych.ox.ac.uk
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

S. Cohrs (2008). Sleep disturbances in patients with schizophrenia. CNS Drugs, 22, 939962. doi:10.2165/00023210-200822110-00004

C. A. Espie , N. M. Broomfield , K. M. A. MacMahon , L. M. MacPhee and L. M. Taylor (2006). The attention-intention-effort pathway in the development of psychophysiologic insomnia. Sleep Medicine Reviews. doi:10.1016/j.smrv.2006.03.002

D. Freeman , G. Dunn , H. Startup , K. Pugh , J. Cordwell , H. Mander , et al. (2015). Effects of cognitive behaviour therapy for worry on persecutory delusions in patients with psychosis (WIT). Lancet Psychiatry, 2, 305313.

D. Freeman , K. Pugh , N. Vorontsova and L. Southgate (2009). Insomnia and paranoia. Schizophrenia Research, 108 (1–3), 280284. doi:10.1016/j.schres.2008.12.001

D. Freeman , H. Startup , E. Myers , A. Harvey , J. Geddes , L.-M. Yu , et al. (2013). The effects of using cognitive behavioural therapy to improve sleep for patients with delusions and hallucinations (the BEST study). Trials, 14, 214. doi:10.1186/1745-6215-14-214

A. G. Harvey (2002). A cognitive model of insomnia. Behaviour Research and Therapy, 40, 869–93. http://www.ncbi.nlm.nih.gov/pubmed/12186352

E. Myers , H. Startup and D. Freeman (2011). Cognitive behavioural treatment of insomnia in individuals with persistent persecutory delusions. Journal of Behavior Therapy and Experimental Psychiatry, 42, 330336. doi:10.1016/j.jbtep.2011.02.004

K. Wulff , D.-J. Dijk , B. Middleton , R. G. Foster and E. M. Joyce (2012). Sleep and circadian rhythm disruption in schizophrenia. British Journal of Psychiatry, 200, 308316. doi:10.1192/bjp.bp.111.096321

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Behavioural and Cognitive Psychotherapy
  • ISSN: 1352-4658
  • EISSN: 1469-1833
  • URL: /core/journals/behavioural-and-cognitive-psychotherapy
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Full text views

Total number of HTML views: 42
Total number of PDF views: 431 *
Loading metrics...

Abstract views

Total abstract views: 462 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 25th April 2017. This data will be updated every 24 hours.