Treating insomnia may reduce mental health problems

September 7, 2017
Treating insomnia may reduce mental health problems. Credit: Shutterstock

Treating insomnia with online cognitive behavioural therapy (CBT) could reduce mental health problems such as anxiety, depression, and paranoia, according to a large randomised controlled trial published today in The Lancet Psychiatry.

The Wellcome-funded study was conducted by researchers at the Sleep and Circadian Neuroscience Institute, University of Oxford. It found that is a driving factor in the occurrence of paranoia, hallucinatory experiences, and other in young adults () with an average age of 25.

The researchers aimed to improve sleep in these individuals in order to determine the effect on mental problems such as paranoia (excessive mistrust), anxiety, and depression. 3,755 university students across the UK were randomised into two groups. One group received online cognitive behaviour therapy (CBT) for insomnia; the other group did not but had access to standard treatments.

This is thought to be the largest ever randomised controlled trial of a psychological for mental health and the first study large enough to determine the effects of treating insomnia on psychotic experiences.

Individuals who received the CBT sleep treatment showed large reductions in insomnia, as well as small, sustained reductions in paranoia and hallucinatory experiences. The treatment also led to improvements in depression, anxiety, nightmares, psychological well-being, and daytime work and home functioning.

Those who received CBT were also less likely over the course of the trial to experience a depressive episode or an anxiety disorder. The research suggests that understanding and treating disrupted sleep could provide a key route for improving mental health.

Daniel Freeman, the study lead and Professor of Clinical Psychology at the University of Oxford and Oxford Health NHS Foundation Trust, said: "Sleep problems are very common in people with , but for too long insomnia has been trivialised as merely a symptom, rather than a cause, of psychological difficulties. This study turns that old idea on its head, showing that insomnia may actually be a contributory cause of mental health problems. A good night's sleep really can make a difference to people's psychological health. Helping people get better sleep could be an important first step in tackling many psychological and emotional problems."

The was delivered through an online programme and provided in six sessions, lasting an average of 20 minutes each, presented by an animated sleep expert1. The sessions included behavioural, cognitive and educational components, such as learning to associate bed with sleep, encouraging people to put time aside to reflect on their day before going to bed, and facilitating a pro-sleep environment. The programme was interactive, with participants' daily sleep diaries used to tailor the advice.

The researchers monitored participants' mental health through a series of online questionnaires at 0, 3, 10 (post treatment) and 22 weeks from the start of the treatment. There was significant drop-out of participants during the trial, with 30% of participants providing no follow-up data. This drop-out rate is in-line with other comparable studies and the large number of trial participants ensured the results are still significant.

Dr Andrew Welchman, Head of Neuroscience and Mental Health at Wellcome, said: "This is an important study that provides further evidence that sleep is an important factor in understanding mental health problems. This study suggests that improving sleep could provide a promising route into early treatment to improve mental health in young people. University students represent a group of young people that have increasingly reported being burdened by problems, and it will be important to determine how well this approach can be applied to other groups in society."

Russell Foster, Head of the Oxford Sleep and Circadian Neuroscience Institute, said: "Sleep disruption is a very common feature of mental illness, yet despite its prevalence the clinical relevance is often overlooked and even when recognised, treatment options are limited. This study is immensely exciting as it not only provides strong evidence for a causal link between psychotic experiences and disruption, but suggests a new therapeutic target for the treatment of psychosis and other mental illnesses. These findings are the perfect example of why the Sleep and Circadian Neuroscience Institute was established."

Explore further: Children's sleep quality linked to mothers' insomnia

More information: Daniel Freeman et al. The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis, The Lancet Psychiatry (2017). DOI: 10.1016/S2215-0366(17)30328-0

Related Stories

Children's sleep quality linked to mothers' insomnia

August 31, 2017
Children sleep more poorly if their mothers suffer from insomnia symptoms - potentially affecting their mental wellbeing and development - according to new research by the University of Warwick and the University of Basel.

Why one teenager may need more—or less—sleep than another

August 30, 2017
Sleep problems contribute to a number of mental health issues in adolescents, researchers say. But a lingering question is whether some teens need more—or less—sleep than others to be healthy and at their best.

Teen insomnia is linked with depression and anxiety

July 30, 2014
A study of high school students by University of Adelaide psychology researchers has shed new light on the links between insomnia-related mental health conditions among teens.

Sleep duration impacts treatment response for depressed patients with insomnia

June 5, 2017
Preliminary results from a new study show that depressed patients with insomnia who sleep seven or more hours per night are more likely to benefit from cognitive behavioral therapy for insomnia (CBTI) and achieve depression ...

Could sleep disruption during pregnancy trigger depression?

March 31, 2017
A Massey University research study is looking to measure the sleep and mental health of new mothers throughout their pregnancy to determine what effect sleep disruption has on depression.

Better sleep feels like winning the lottery

March 16, 2017
Improving your sleep quality is as beneficial to health and happiness as winning the lottery, according to research by the University of Warwick.

Recommended for you

Schizophrenia drug development may be 'de-risked' with new research tool

November 22, 2017
Researchers at Columbia University Medical Center (CUMC) and the New York State Psychiatric Institute (NYSPI) have identified biomarkers that can aid in the development of better treatments for schizophrenia.

Study finds infection and schizophrenia symptom link

November 22, 2017
If a mother's immune system is activated by infection during pregnancy, it could result in critical cognitive deficits linked to schizophrenia in her offspring, a University of Otago study has revealed.

Self-harm, suicide attempts climb among US girls, study says

November 21, 2017
Attempted suicides, drug overdoses, cutting and other types of self-injury have increased substantially in U.S. girls, a 15-year study of emergency room visits found.

Car, stroller, juice: Babies understand when words are related

November 20, 2017
The meaning behind infants' screeches, squeals and wails may frustrate and confound sleep-deprived new parents. But at an age when babies cannot yet speak to us in words, they are already avid students of language.

Simple EKG can determine whether patient has depression or bipolar disorder

November 20, 2017
A groundbreaking Loyola Medicine study suggests that a simple 15-minute electrocardiogram could help a physician determine whether a patient has major depression or bipolar disorder.

Non-fearful social withdrawal linked positively to creativity

November 20, 2017
Everyone needs an occasional break from the social ramble, though spending too much time alone can be unhealthy and there is growing evidence that the psychosocial effects of too much solitude can last a lifetime.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.