Cognitive Behavioral Therapy Improves Sleep for Prisoners with Insomnia
Nearly three in four prisoners with insomnia experienced major improvements to their sleep and wellbeing after receiving cognitive behavioral therapy, according to a new U.K. study published in the journal Behavioural Sleep Medicine.
The findings show that a single one-hour session of cognitive behavioral therapy (CBT) 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.
In the first of its kind study, researchers from the Centre for Sleep Research at Northumbria University in Newcastle, England worked with 30 male prisoners who had all reported difficulty sleeping.
The participants were all Category C inmates, between the ages of 21 and 60, from a prison in England. A Category C prisoner is defined as an inmate who cannot be trusted in open conditions, but who is unlikely to try and escape.
Depending on their crime and the prison, 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 levels of the space in which they live.
Because of these factors, around 61% of prison inmates suffer from chronic insomnia and the likelihood is that for many of them the insomnia started during their time in prison. Chronic lack of sleep can lead to anger, aggression and even suicide attempts, all creating an additional burden on the system.
Therefore, any improvement to their sleep quality can have a noticeable impact and reduce their use of prison health care services.
After a 2015 study had shown that a one-hour CBT session led to a 60% reduction in insomnia symptoms in the general population, the researchers wanted to see whether the same therapy would be even more effective in treating prisoners’ insomnia and mood.
The new findings show that one month after receiving the treatment, the prisoners reported not only a significant reduction in their insomnia, but also their anxiety and depressive symptoms. Similar to the study with the general population, 73% of prisoners reported that their insomnia had reduced following the treatment session.
“We believe that the high levels of insomnia in prisoners are due to many factors that most people have full control over,” said Professor Jason Ellis, Director of the Northumbria Centre for Sleep Research.
“The line between daytime and nighttime 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.”
“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,” added Ellis.
The researchers also want to investigate the impact this therapy may have on suicide, as they know there is a strong link between poor sleep and suicide.
Source: Northumbria University
Pedersen, T. (2018). Cognitive Behavioral Therapy Improves Sleep for Prisoners with Insomnia. Psych Central. Retrieved on September 20, 2020, from https://psychcentral.com/news/2018/11/16/cognitive-behavioral-therapy-improves-sleep-for-prisoners-with-insomnia/140421.html