Three-quarters of prisoners struggling to sleep have
reported major improvements to their sleep and wellbeing after receiving
cognitive behavioural therapy to treat their insomnia.
Experts from Northumbria University, Newcastle have found
that a single one-hour session of cognitive behavioural therapy was effective
in preventing the development of chronic insomnia in 73% of prisoners. In
addition, the inmates also reported that the therapy made notable improvements
to their anxiety and depression.
The findings of the study, the first of its kind in the
world, have been published in the latest edition of the journal Behavioural Sleep Medicine.
In the study, researchers from the Northumbria
Centre for Sleep Research worked with 30 male prisoners who had all
reported difficulty sleeping. They were all Category C inmates aged between
21-60 from a prison in the North East of England. A Category C prisoner is
described as an individual who cannot be trusted in open conditions, but who is
unlikely to try and escape.
Depending on their crime and the prison they are based in,
inmates can spend up to 22 hours a day in their cells. They have
strictly-enforced routines, limited access to sunlight, exercise and physical
activity and no control over the noise and comfort of the space they live in.
As a result, it is believed that approximately 61% of prison
inmates suffer from chronic insomnia and the likelihood is that for many of
them the insomnia started whilst they were in prison. This can lead to anger,
aggression and even suicide attempts, all creating an additional burden on the
system. This means any improvement to their sleep quality can have a noticeable
impact and reduce their use of prison health care services.
After a previous study in 2015 had found that a one-hour
cognitive behavioural therapy session led to a 60% reduction in insomnia
symptoms in the general population, the researchers wanted to assess whether
the same therapy would be even more effective in treating prisoners’ insomnia
and mood.
The results were successful. One month after receiving the
treatment, the prisoners reported not only a significant reduction in their
insomnia, but also their anxiety and depressive symptoms. As per the study with
the general population, 73% of prisoners reported that their insomnia had
reduced following the cognitive behavioural therapy session.
Professor
Jason Ellis, Director of the Northumbria Centre for Sleep Research,
explained: “We believe that the high levels of insomnia in prisoners are due to
many factors that most people have full control over.
“The line between day-time and night-time environments is
blurred for inmates, who spend a significant amount of time in their cells.
Their bedroom becomes their living space, and not just the space where they
sleep. They have less autonomy over their routine and certainly over their
bedroom environment. As such, normal access to sleep cues are likely to be
harder in this environment.
“These factors combined with the stress of imprisonment and
all that it entails is likely to make inmates far more vulnerable to insomnia.”
Professor Ellis added: “We knew from an earlier study with
the general population that this single session of therapy also had an impact
on anxiety and depression, so we were certainly pleased to see the same thing
happen in a prison context. The fact that we were reducing symptoms significantly
was very welcome news indeed.
“Now that we have seen these results, I would like to see
this form of therapy being rolled out in prisons nationally and
internationally. If we look at the costs alone in terms of insomnia, managing
it certainly makes good sense.”
The researchers hope to look at the impact that this therapy
has on suicides in future as they know there is a strong relationship between
poor sleep and suicide.
The study was undertaken by researchers from the Northumbria
Centre for Sleep Research, based in Northumbria University’s Department of
Psychology, UK, and the Department of Psychiatry and Behavioural Sciences in
the University of Texas, USA.
Their paper,Managing Acute Insomnia in Prison: Evaluation of a ‘one-shot’ cognitive behavioural therapy for insomnia (CBT-I) intervention, is now available in
Behavioural Sleep Medicine
