Most of us will know the frustration of being unable to fall
asleep at night – but for those who experience sleep issues for weeks or even
months at a time, the impact on their physical and mental health can be severe.
The Covid-19 pandemic led to a significant rise in the number
of people suffering from sleep disorders, particularly acute insomnia – defined
as when someone struggles to fall asleep for at least three nights each week
for a period of between two weeks and three months.
After looking for new ways to support patients during
lockdown periods, researchers at Northumbria University believe they have found
a solution which is simple, effective and low-cost following a trial – the results of which have been published in Sleep, the official journal of the Sleep Research Society.
With traditional treatment techniques such as cognitive
behavioural therapy for acute insomnia not possible during the pandemic due to
lock-down restrictions, scientists from Northumbria’s Centre for Sleep Research
decided to test if techniques and advice provided in a self-help leaflet,
normally used alongside in-person therapy sessions, could prove effective when
used as a stand-alone resource.
They conducted an online trial, during which they asked
people identifying as suffering from acute insomnia to follow the guidance
contained in the leaflet in their own homes.
This included:
- Keeping their bedroom cool, dark, and quiet
- Keeping a sleep diary recording what time they go to bed, get to sleep, if they wake up in the night and for how long, and what time they get up
- Only using their bedroom for sleep and only sleeping in their bed at night
- Winding down an hour before bed, including writing down any worries they have
- Trying distraction techniques such as word games and visualisations while trying to get to sleep.
The results showed that even after just one-week
participants reported reduced insomnia severity, as well as reduced anxiety and
depression. And these positive effects were still reported three months after
the participant began using the self-help techniques.
The trial was led by Dr Greg Elder, Associate Director of the Northumbria Centre for Sleep Research.
As he explains: “Stressful life events can often lead to
acute insomnia, and for most of us the Covid-19 pandemic was an unusually stressful
experience. The leaflet was something we were already using as an accompaniment
to group workshops, but during lockdown we decided to offer it to people
suffering from sleep disorders and the results were incredibly positive.”
During the trial 344 people downloaded the leaflet to use at
home, including participants from the UK, USA, Europe and Australia.
As well as 241 people who identified as suffering from acute
insomnia, 103 people who considered themselves as ‘good sleepers’ also took
part, with the aim of discovering whether carrying out the self-help techniques
could prevent sleep issues occurring.
As Dr Elder explains: “Part of the study was to find out if
a ‘sleep vaccination’ approach was feasible, whereby good sleepers carry out
preventative measures to protect their good sleep health, in the same way you
might eat well and exercise to maintain physical health. Of the good sleepers
who took part in the trial, their sleep quality did not get any worse overall,
demonstrating that the techniques may still be beneficial even in those without
sleep disorders.”
The research team now hope to carry out further research,
working specifically with groups of people who are more likely to come under
increased stress which could impact on their sleep habits, for example
healthcare workers.
As Dr Elder explains: “This is a simple and low-cost
intervention and completely drug free, which is especially beneficial to older
patients who, for example, might not be able to take insomnia medication. We
hope it can be made available more widely in future so that even more people
can benefit from these techniques.”
The research paper, entitled An online behavioural self-help intervention rapidly improves acute insomnia severity and subjective mood during the COVID-19 pandemic: a stratified randomised controlled trial, was written by Dr Elder and
colleagues from the Northumbria Centre for Sleep Research, as well as the
University of Freiburg, in Germany.
