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Dysfunctional Cognitions about Sleep in Psychiatric Patients


Journal of Psychiatric Practice®: May 2014 - Volume 20 - Issue 3 - p 188–195
doi: 10.1097/01.pra.0000450318.14236.36

The optimal management of sleep problems is a significant challenge, particularly in patients with psychiatric illness, because disturbed sleep is a known risk factor for relapse. This study used the short Dysfunctional Beliefs and Attitudes Scale to assess beliefs about sleep in adults with acute psychiatric disorders (N=100) recruited from inpatient and outpatient clinics. The subjects showed highly dysfunctional beliefs and attitudes about sleep and held diverse opinions about, but had low confidence in, their own capacity for optimal sleep management. They did not report excessive daytime sleepiness. We conclude that individuals with acute psychiatric illness worry significantly about their sleep and hold more dysfunctional beliefs about sleep than people without psychiatric illness. The absence of excessive daytime sleepiness in this sample, although counterintuitive, is consistent with findings in other studies. Given that two thirds of the sample expressed interest in non-pharmacological strategies to better manage their sleep problems, cognitive reshaping therapies appear to have clinical potential as alternatives to hypnosedative medication once a comprehensive sleep workup has excluded a physical sleep disorder such as obstructive sleep apnea. Dysfunctional beliefs and high concern about sleep offer potential targets for psychotherapy. (Journal of Psychiatric Practice 2014;20:188–195)

HUTHWAITE, MILLER, MCCARTNEY, and ROMANS: University of Otago School of Medicine, Wellington, New Zealand

The Wellington Medical Research Foundation, Inc. supported this research. It was conducted with the assistance of Capital and Coast District Health Board, whose staff facilitated the data collection. We thank the 100 people who participated in this study. We would also like to acknowledge the statistical assistance and guidance of Dr James Stanley (medical biostatistician) from the University of Otago.

The authors declare no conflicts of interest.

Please send correspondence to: Prof Sarah Romans, Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, PO Box 7343, Wellington, 6242, New Zealand.

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