Abstract
Objectives: A recent randomised controlled feasibility trial showed that sleep problems in young people at-risk of psychosis can be successfully treated with psychological therapy and that this may bring additional benefits such as reducing depression, anxiety, and paranoia. Here we report participants’ qualitative experience of sleep problems and therapy.
Design: A peer methods qualitative study employing reflexive thematic analysis.
Methods: Semi-structured interviews, co-facilitated by peer researchers, were conducted with 16 young patients at-risk of psychosis and having sleep problems who took part in the SleepWell Trial (ISRCTN85601537). Ten interviewees had received the 12-week sleep therapy.
Results: Four themes were generated: 1) The challenge to access mental health treatment (‘bouncing between services’); 2) Sleep problems and mental health difficulties are intertwined (‘an obvious link’); 3) Flexibility in therapy provision matters (‘tailored to me as a person’); 4) Improving sleep leads to wider benefits (‘fixing the sleep helped everything else’). Participants described a frustrating journey to access mental health treatment, marked by rejection and invalidation, which resulted in hopelessness and often resignation. The interaction between sleep disruption and other mental health difficulties was seen as obvious. Treatment for sleep problems was highly valued. The clear focus, therapeutic style, and flexible delivery of the treatment was seen to created patient ownership, active engagement, and hope. Participants described transformative changes: better sleep, fewer voices and fears, and improved mood and confidence. Improving sleep made a difference to everyday life.
Conclusions: Treating sleep problems in people at-risk of psychosis is highly valued and often brings rapid and widespread improvements across a range of domains.
Design: A peer methods qualitative study employing reflexive thematic analysis.
Methods: Semi-structured interviews, co-facilitated by peer researchers, were conducted with 16 young patients at-risk of psychosis and having sleep problems who took part in the SleepWell Trial (ISRCTN85601537). Ten interviewees had received the 12-week sleep therapy.
Results: Four themes were generated: 1) The challenge to access mental health treatment (‘bouncing between services’); 2) Sleep problems and mental health difficulties are intertwined (‘an obvious link’); 3) Flexibility in therapy provision matters (‘tailored to me as a person’); 4) Improving sleep leads to wider benefits (‘fixing the sleep helped everything else’). Participants described a frustrating journey to access mental health treatment, marked by rejection and invalidation, which resulted in hopelessness and often resignation. The interaction between sleep disruption and other mental health difficulties was seen as obvious. Treatment for sleep problems was highly valued. The clear focus, therapeutic style, and flexible delivery of the treatment was seen to created patient ownership, active engagement, and hope. Participants described transformative changes: better sleep, fewer voices and fears, and improved mood and confidence. Improving sleep made a difference to everyday life.
Conclusions: Treating sleep problems in people at-risk of psychosis is highly valued and often brings rapid and widespread improvements across a range of domains.
| Original language | English |
|---|---|
| Journal | British Journal of Clinical Psychology |
| Early online date | 6 Jul 2025 |
| DOIs | |
| Publication status | E-pub ahead of print - 6 Jul 2025 |
Keywords
- insomnia
- schizophrenia
- clinical high risk
- at risk mental state
- intervention
- CBT
- cognitive therapy
