An examination of daytime pre-sleep factors contributing to night-time sleep disturbance in the context of Insomnia and Psychosis.

Abstract

The aim of this thesis was to explore which day-time pre-sleep factors contribute to night-time sleep disturbance in the context of insomnia and psychosis. It is presented to the reader as three separate papers. 1) A systematic literature review exploring the utility of physical activity interventions for improving sleep outcome for people presenting with insomnia disorder and insomnia symptoms. 2) An empirical study investigating which day-time pre-sleep factors contribute to sleep disturbance for people with psychosis.3) A critical appraisal and personal reflection of the whole research process. Paper one presents a systematic review of the existing literature that explores physical activity interventions for improving sleep outcome for people presenting with insomnia disorder and insomnia symptoms. Thirteen articles were identified which met the review criteria. The mythological quality and evidence derived from the studies was mixed; however, there was evidence that exercise has the potential to improve sleep outcomes for people with insomnia disorder and insomnia symptoms. Recommendations for future research were suggested along with potential clinical implications which arose from the review. The empirical study presented in paper two used experience sampling methodology to explore which day-time pre-sleep factors contribute to night-time sleep disturbance for 21 people with psychosis. Physical activity, social interaction and sleep preoccupation served as primary variables, whereas negative affect, stress, arousal, napping, and psychotic symptomatology served as exploratory variables. Multilevel modelling was performed to evaluate associations between these predictor variables and objective sleep parameters including Total Sleep Time (TST), Sleep Efficiency (SE) and Sleep Fragmentation (SF). Social interaction was the only significant predictor found; increased social interaction predicted increased TST and increased SE the following night. Methodological strengths and limitations, clinical implications and ideas for future research are also discussed. Paper three provides the reader with a critical reflection of the whole research process, including a discussion of the background literature, rationale for topic choice, methodological and personal reflections, clinical implications, and directions for future research.

Date of Award	31 Dec 2017
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Gillian Haddock (Supervisor) & Lynsey Gregg (Supervisor)