How sleep in patients with serious mental illness is recorded and treated, and its impact on service engagement

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2024-09-10 DOI:10.1016/j.sleep.2024.09.002

Aviva Stafford , Sheri Oduola , Sarah Reeve

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引用次数: 0

Abstract

Background

Sleep and mental health share a bidirectional relationship whereby problems in one exacerbate the other. Accordingly, sleep problems are frequent and severe in serious mental illness (SMI) populations, exacerbating SMI symptoms. This study examined the documentation and treatment of sleep problems within anonymised clinical records of SMI patients, and their association with attendance rates and number of appointments scheduled.

Methods

Patient records between 01.09.2021 and 31.08.2022 were identified and relevant records (n = 229) extracted from an NHS Trust database. Content analysis was used to assess documentation and treatment of sleep problems and Chi-square tests were used to assess demographic differences. Mann-Whitney U tests were used to compare attendance rates and number of appointments scheduled between patients with/without sleep problems.

Results

Most (n = 170; 84 %) patients with sleep problems had no or minimal assessment of the sleep problem within their records. Patients were primarily offered no (n = 115; 57 %) or non-recommended (n = 69; 34 %) sleep treatment. More outpatients were offered no sleep treatment (n = 89; 64 %) than inpatients (n = 26; 41 %) (p = .002) whilst more inpatients were offered non-recommended sleep treatments (n = 33; 52 %) than outpatients (n = 36; 26 %) (p < .001). No significant associations were found between sleep and attendance or appointments scheduled.

Conclusions

There is a lack of routine clinical attention to sleep assessment and treatment in SMI groups. Where sleep is addressed, treatment often conflicts with guidelines. Improved sleep assessment and treatment could significantly enhance current SMI patient care.

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如何记录和处理重症精神病患者的睡眠情况及其对服务参与的影响

背景睡眠与精神健康之间存在双向关系，其中一方出现问题会加重另一方的病情。因此，睡眠问题在严重精神疾病（SMI）人群中十分常见且严重，会加重 SMI 症状。本研究调查了 SMI 患者匿名临床记录中有关睡眠问题的记录和治疗情况，以及这些记录与就诊率和预约次数之间的关系。采用内容分析法评估睡眠问题的记录和治疗情况，采用卡方检验法评估人口统计学差异。曼-惠特尼U检验用于比较有/无睡眠问题患者的就诊率和预约次数。结果大多数（n=170；84%）有睡眠问题的患者在其记录中没有对睡眠问题进行评估或评估极少。患者主要未接受睡眠治疗（115 人；57%）或未接受建议的睡眠治疗（69 人；34%）。门诊患者未接受睡眠治疗的人数（n = 89; 64 %）多于住院患者（n = 26; 41 %）（p = .002），而住院患者未接受推荐睡眠治疗的人数（n = 33; 52 %）多于门诊患者（n = 36; 26 %）（p < .001）。在睡眠与出勤率或预约时间之间没有发现明显的关联。结论在 SMI 群体中，缺乏对睡眠评估和治疗的常规临床关注。在涉及睡眠问题时，治疗方法往往与指南相冲突。改善睡眠评估和治疗可大大提高目前对 SMI 患者的护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.