The Experience of Poor Sleep and its Consequences: a Qualitative Study involving People referred for Cognitive-Behavioural Management of Chronic Insomnia
Restricted accessResearch articleFirst published online May, 2008
The Experience of Poor Sleep and its Consequences: a Qualitative Study involving People referred for Cognitive-Behavioural Management of Chronic Insomnia
Six patients seeking treatment for chronic insomnia participated in two focus groups as a first stage of questionnaire design. Despite the low attendance at the groups, the results are presented because they offer an illuminating insight into the experience of insomnia.
The participants reported major disruption to their daytime activities, especially in terms of safety and reliability, which could affect their life choices and, they believed, could affect their health. They did not feel understood by others, especially doctors, and wanted better information about insomnia and its management. The study also highlighted practical problems involved in running focus groups as well as ethical considerations that arise when conducting research with current patients. These issues are discussed along with the implications of the research, which raise questions about the role of sleep in maintaining lifestyle balance.
Further research with a larger and more varied group is recommended in order to consolidate the findings and it is suggested that further reflection is necessary to determine the extent to which sleep is a legitimate concern for occupational therapists.
AlfordCWilsonS (2008) Effects of hypnotics on sleep and quality of life in insomnia. In: VersterJCPandi-PerumalSRStreinerD, eds. Sleep and quality of life in medical illnesses. Totowa, NJ: Humana Press, ch. 7.
2.
American Academy of Sleep Medicine (2001) The international classification of sleep disorders, revised: diagnostic and coding manual. Chicago, IL: American Academy of Sleep Medicine.
3.
ArkseyHSloperP (1999) Disputed diagnoses: the cases of RSI and childhood cancer. Social Science and Medicine, 49 (4), 483–97.
4.
BackhausJJunghannsKBornJHohausKFaaschFHohagenF (2006) Impaired declarative memory consolidation during sleep in patients with primary insomnia: influence of sleep architecture and nocturnal cortisol release. Biological Psychiatry, 60 (12), 1324–30.
5.
BanniganKHughesSBoothM (2007) Research is now every occupational therapist's business. British Journal of Occupational Therapy, 70 (3), 95.
6.
BarnittRPartridgeC (1999) The legacy of being a research subject: follow-up studies of participants in therapy research. Physiotherapy Research International, 4 (4), 250–61.
7.
BoydW (1998) Armadillo. London: Penguin.
8.
BylesJEMishraGDHarrisMA (2005) The experience of insomnia among older women. Sleep, 28 (8), 972–79.
9.
CaraEMacRaeA (2005) Psychosocial occupational therapy: a clinical practice. 2nd ed.Clifton Park, NY: Thomson Delmar Learning.
10.
CareyTJMoulDEPilkonisPGermainABuysseDJ (2005) Focusing on the experience of insomnia. Behavioral Sleep Medicine, 3 (2), 73–86.
11.
ChristiansenCHBaumCM (1997) Understanding occupation: definitions and concepts. In: ChristiansenCHBaumCM, eds. Occupational therapy: enabling function and wellbeing. 2nd ed.Thorofare, NJ: Slack, 3–25.
12.
ChristiansenCHMatuskaKM (2006) Lifestyle balance: a review of concepts and research. Journal of Occupational Science, 13 (1), 49–61.
13.
CollierESkittGCuttsH (2003) A study on the experience of insomnia in a psychiatric inpatient population. Journal of Psychiatric and Mental Health Nursing, 10 (6), 697–704.
14.
CrouchRAlersV (2005) Occupational therapy in psychiatry and mental health. London: Whurr.
15.
EcclestonCde C WilliamsAStaintonRogers W (1997) Patients' and professionals' understanding of the causes of chronic pain: blame, responsibility and identity protection. Social Science and Medicine, 45 (5), 699–709.
16.
EtheringtonK (2001) Research with ex-clients: a celebration and extension of the therapeutic process. British Journal of Guidance and Counselling, 29 (1), 5–19.
17.
FarnworthL (2003) Time use, tempo and temporality: occupational therapy's core business or someone else's business. Australian Occupational Therapy Journal, 50 (3), 116–26.
18.
FinchamLCoppGCaldwellKJonesLTookmanA (2005) Supportive care: experiences of cancer patients. European Journal of Oncology Nursing, 9 (3), 258–68.
19.
FinlayL (2002) ‘Outing’ the researcher: the provenance, process and practice of reflexivity. Qualitative Health Research, 12 (4), 531–45.
20.
FinlayL (2006) ‘Rigour’, ‘ethical integrity’, or ‘artistry’? Reflexively reviewing criteria for evaluating qualitative research. British Journal of Occupational Therapy, 69 (7), 319–26.
21.
GreenAPayneSABarnittRE (2004) Illness representations among people with non-epileptic seizures attending a neuropsychiatry clinic: a qualitative study based on the self-regulation model. Seizure, 13 (5), 331–39.
22.
GreenAHicksJWeekesRWilsonS (2005) A cognitive-behavioural group intervention for people with chronic insomnia: an initial evaluation. British Journal of Occupational Therapy, 68 (11), 518–22.
HarveyAGTangNKY (2003) Cognitive behaviour therapy for primary insomnia: can we rest yet?Sleep Medicine Reviews, 7 (3), 237–62.
25.
HislopJArberS (2003a) Sleepers wake! The gendered nature of sleep disruption in mid-life women. Sociology, 3 (4), 695–711.
26.
HislopJArberS (2003b) Understanding women's sleep management: beyond medicalization and healthicization?Sociology of Health and Illness, 25 (7), 815–37.
27.
HollisVOpenshawSGobleR (2002) Conducting focus groups: purpose and practicalities. British Journal of Occupational Therapy, 65 (1), 2–8.
28.
JenkinsonCCoulterAWrightL (1993) Short form 36 (SF36) health survey questionnaire: normative data for adults of working age. British Medical Journal306 (6890), 1437–40.
29.
LégerDScheuermaierKPhilipPPaillardMGuilleminaultC (2001) SF-36: evaluation of quality of life in severe and mild insomniacs compared with good sleepers. Psychosomatic Medicine, 63, 49–55.
30.
MacLeanAWDaviesDRTThieleK (2003) The hazards and prevention of driving while sleepy. Sleep Medicine Reviews, 7 (6), 507–21.
31.
MartinP (2002) Counting sheep: the science and pleasures of sleep and dreams. London: Harper Collins.
32.
MayersCA (2007) Practice and reseach: discovering what people need. British Journal of Occupational Therapy, 70 (5), 183.
33.
MeyerA (1977) The philosophy of occupational therapy. American Journal of Occupational Therapy, 31 (10), 639–42. (Originally published in 1922.) Millward LJ (1995) Focus groups. In: BreakwellGM, HammondS, Fyfe-SchawC, eds. Research methods in psychology.London: Sage, 274–92.
34.
MorinCM (2003) Measuring outcomes in randomized clinical trials of insomnia treatments. Sleep Medicine Reviews, 7 (3), 263–79.
35.
MorinCMEspieCA (2003) Insomnia: a clinical guide to assessment and treatment. New York, NY: Kluwer Academic/Plenum Publishers.
36.
National Institute for Clinical Excellence (2004) Guidance on the use of zaleplon, zolpidem and zopiclone for the short-term management of insomnia. London: NICE.
37.
NissenCKloepferCNofzingerEAFeigeBVoderholzerURiemannD (2006) Impaired sleep-related memory consolidation in primary insomnia — a pilot study. Sleep, 29 (8), 1068–73.
38.
OhayonMM (2005) Comment on Phillips B; Mannino DM. Does insomnia kill?Sleep, 28 (9), 1043–44.
39.
PhillipsBManninoDM (2005) Does insomnia kill?Sleep, 28 (8), 965–71.
40.
ReeMHarveyA (2004) Insomnia. In: Bennett-LevyJButlerGFennellMHackmannAMuellerMWestbrookD, eds. Oxford guide to behavioural experiments in cognitive therapy. Oxford: Oxford University Press, 287–305.
