Prevalence, associated factors and management of insomnia in prison populations: an integrative review

Objectives: The aim of this review was to identify existing evidence concerning insomnia in a prison population.Methods: An exploratory integrative review was utiltised to collate, describe and discuss the prison-sleep literature by exploring potential themes and study quality. Cochrane Library, EMBASE, MEDLINE, Evidence Based Medicine Reviews and PsycINFO databases were examined against appropriate search operators for insomnia (e.g. sleep disturbance, sleep problems, hypnotic) and prison (e.g.incarceration, jail, inmate) terms. Several key comorbidity reports were also included.Results: The review identified 33 articles that explored sleep in a prison establishment. A thematic analysis identified five key themes: the prevalence of sleep problems, the comorbidity of sleep problems, psychiatric disorder and substance misuse, the influence of the prison environment on sleep, reliance on hypnotic medication and the effectiveness of sleep management. An estimated insomnia prevalence rate ranged from 10.9% to 81.0% depending on sex, age,sentencing type or insomnia criteria used. Non-pharmacological treatments such as meditation and relaxation techniques were also identified as a means of improving sleep.Conclusions: Insomnia seems to be a common condition in a prison setting. There is some consistency between country in terms of insomnia prevalence, associated factors and general management. However, the criteria, measure and method used to identify insomnia or sleep difficulties differed across these themes. This makes itdifficult to ascertain clarity and certainty in the results. More research is needed to identify exactly how problematic insomnia is in the world prison estate.Disclosure: Nothing to disclose.