Sleep Disturbances in People with Major Depressive Disorder: A Qualitative Descriptive Study of Patient Experiences in Danish Outpatient Psychiatric Care.

Abstract

To describe how patients with major depressive disorder (MDD) experience support for sleep disturbances in Danish outpatient psychiatric care and which pharmacological and non-pharmacological strategies they report using and perceiving as helpful in everyday life. Qualitative descriptive study. Semi-structured individual interviews were conducted with 12 adults diagnosed with MDD who were receiving ongoing outpatient psychiatric treatment. Data were analysed inductively using Braun and Clarke's reflexive thematic analysis. The Standards for Reporting Qualitative Research (SRQR) checklist guided reporting to enhance transparency and rigour. Six women and six men [mean (SD) age = 52 (19) years] participated. Participants described a range of strategies to manage sleep disturbances, including prescribed sleep medication, physical activity, relaxation techniques, and, in some cases, self-directed use of alcohol or cannabis. Across interviews, participants reported limited professional attention to sleep problems in outpatient care, describing fragmented guidance, a predominant reliance on pharmacological solutions, and a lack of systematic follow-up. Patients with MDD perceived insufficient and inconsistent support for managing sleep disturbances in outpatient psychiatric care. The findings suggest a gap between clinical guidelines and everyday clinical practice, with limited integration of non-pharmacological sleep interventions. Strengthening systematic sleep assessment and nurse-led holistic approaches may improve care quality and support recovery in this population.