Dataset Information

The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis.

ABSTRACT:

Background

Sleep difficulties might be a contributory causal factor in the occurrence of mental health problems. If this is true, improving sleep should benefit psychological health. We aimed to determine whether treating insomnia leads to a reduction in paranoia and hallucinations.

Methods

We did this single-blind, randomised controlled trial (OASIS) at 26 UK universities. University students with insomnia were randomly assigned (1:1) with simple randomisation to receive digital cognitive behavioural therapy (CBT) for insomnia or usual care, and the research team were masked to the treatment. Online assessments took place at weeks 0, 3, 10 (end of therapy), and 22. The primary outcome measures were for insomnia, paranoia, and hallucinatory experiences. We did intention-to-treat analyses. The trial is registered with the ISRCTN registry, number ISRCTN61272251.

Findings

Between March 5, 2015, and Feb 17, 2016, we randomly assigned 3755 participants to receive digital CBT for insomnia (n=1891) or usual practice (n=1864). Compared with usual practice, the sleep intervention at 10 weeks reduced insomnia (adjusted difference 4·78, 95% CI 4·29 to 5·26, Cohen's d=1·11; p<0·0001), paranoia (-2·22, -2·98 to -1·45, Cohen's d=0·19; p<0·0001), and hallucinations (-1·58, -1·98 to -1·18, Cohen's d=0·24; p<0·0001). Insomnia was a mediator of change in paranoia and hallucinations. No adverse events were reported.

Interpretation

To our knowledge, this is the largest randomised controlled trial of a psychological intervention for a mental health problem. It provides strong evidence that insomnia is a causal factor in the occurrence of psychotic experiences and other mental health problems. Whether the results generalise beyond a student population requires testing. The treatment of disrupted sleep might require a higher priority in mental health provision.

Funding

Wellcome Trust.

SUBMITTER: Freeman D

PROVIDER: S-EPMC5614772 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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Publications

The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis.

Freeman Daniel D Sheaves Bryony B Goodwin Guy M GM Yu Ly-Mee LM Nickless Alecia A Harrison Paul J PJ Emsley Richard R Luik Annemarie I AI Foster Russell G RG Wadekar Vanashree V Hinds Christopher C Gumley Andrew A Jones Ray R Lightman Stafford S Jones Steve S Bentall Richard R Kinderman Peter P Rowse Georgina G Brugha Traolach T Blagrove Mark M Gregory Alice M AM Fleming Leanne L Walklet Elaine E Glazebrook Cris C Davies E Bethan EB Hollis Chris C Haddock Gillian G John Bev B John Bev B Coulson Mark M Fowler David D Pugh Katherine K Cape John J Moseley Peter P Brown Gary G Hughes Claire C Obonsawin Marc M Coker Sian S Watkins Edward E Schwannauer Matthias M MacMahon Kenneth K Siriwardena A Niroshan AN Espie Colin A CA

The lancet. Psychiatry 20170906 10

<h4>Background</h4>Sleep difficulties might be a contributory causal factor in the occurrence of mental health problems. If this is true, improving sleep should benefit psychological health. We aimed to determine whether treating insomnia leads to a reduction in paranoia and hallucinations.<h4>Methods</h4>We did this single-blind, randomised controlled trial (OASIS) at 26 UK universities. University students with insomnia were randomly assigned (1:1) with simple randomisation to receive digital ...[more]

PMID: 28888927

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Dataset Information

The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis.

Background

Methods

Findings

Interpretation

Funding

Publications

The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis.

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