Background: Sleep disturbance, including insomnia disorder, is common among
patients with chronic health conditions, and is associated with psychological
difficulties and impaired health-related quality of life (HRQoL). Less is known about
whether a similar relationship exists in individuals with chronic health conditions
who do not have a clinical diagnosis of sleep disturbance (NCSD). Recent evidence
suggests that Cognitive Behavioural Therapy (CBT) in the form of self-help (SH) is
an effective treatment for individuals with chronic health conditions and has the
advantage of low cost and ease of access. Any form of sleep disturbance may be
perceived as problematic for individuals with chronic health conditions. This study
aims to: a) examine whether the NCSD population with chronic health conditions at
baseline have poor sleep quality, insomnia symptoms, high levels of psychological
distress (anxiety, depression and stress), sleep-related dysfunctional beliefs and
impaired HRQoL, and b) assess the effectiveness of the CBT-SH booklet.
Method: Participants were recruited from outpatient clinics and received a 6-week
CBT-SH booklet for sleep-related problems. Outcome measures included evaluations
of subjective sleep quality and the severity of insomnia symptoms, psychological
distress (anxiety, depression and stress) sleep-related dysfunctional beliefs and
HRQoL. Measures were completed before and after the intervention.
Results: Forty-nine participants (44 females) completed the study. Prior to the
intervention, 46 participants reported poor sleep quality and 47 participants reported
clinical or subthreshold insomnia. Mean scores for the measures of psychological
distress indicated moderate levels of anxiety, depression and stress and sleep-related
dysfunctional beliefs respectively. HRQoL was also impaired. Following the CBT
intervention, participants showed significant improvements in sleep outcomes, sleeprelated
dysfunctional and stress levels. No significant differences were found in
HRQoL depression and anxiety outcomes.
Conclusion: A brief CBT-SH booklet for sleep-related problems is effective for
patients with chronic health conditions and NCSD in clinical settings.awd_pdtunpub2081_ethesesunpu
