Improving Sleep among Adult Patients with Insomnia Disorder: A Quality Improvement Project

Abstract

Background

The Centers for Disease Control and Prevention (CDC) reported that between 28.5% and 44.1% of adults in the US sleep less than seven hours nightly.

Aims

The aim of this quality improvement project was to improve sleep quality and duration among patients aged 40 and older with insomnia disorder in an outpatient mental health clinic.

Methods

Patients diagnosed with insomnia disorder who were sleeping less than seven hours at least three nights weekly participated in the project (n = 20). Sleep hygiene education was provided and participants kept a sleep diary. The duration and quality of sleep was evaluated by comparing the information recorded in the diaries with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition description of insomnia disorder.

Results

All participants achieved improvement to 6–8 hours of restful sleep nightly.

Keywords

insomnia sleep hygiene outpatient mental health quality improvement

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References

American Psychiatric Association. (2013a). Sleep-wake disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Page 361.

American Psychiatric Association. (2013b). Diagnostic and statistical manual of mental disorders (5th ed.).

Bragantini

, Silversten

, Gehrman

, Lydersen

, & Guzey

I. C.

(2019). Differences in anxiety levels among symptoms of insomnia: The HUNT study. Sleep Health, 5, 270–75. https://doi.org/10.1016/j.sleh.2019.01.002.

Bragg

, Benich

J. J.

, Christian

, Visserman

, & Freedy

(2019). Updates in insomnia diagnosis and treatment. The International Journal of Psychiatry in Medicine, 54, 275–89. https://doi.org/10.1177/0091217419860716.

Centers for Disease Control and Prevention. (2017). Short sleep duration among US adults. CDC - Data and Statistics - Sleep and Sleep Disorders.

Dos Santos

M. A.

, Conceicao

A. P.

, Ferretti-Rebustini

R. E. L.

, Ciol

M. A.

, Heithkemper

M. M.

, & Cruz

D. A. L. M.

(2018). Non-pharmacological interventions for sleep and quality of life: A randomized pilot study. Randomized Controlled Trials, 14(26), e3079. https://doi.org/10.1590/1518-8345.2598.3079.

Lucena

, Polesei

D. N.

, Poyares

, Bittencourt

, Andersen

M. L.

, Tufk

, & Hachul

(2020). The association of insomnia and quality of life: Sao Paulo epidemiologic sleep study (EPISONO). Sleep Health, 6, 629–635. https://doi.org/10.1016/j.sleh.2020.03.002.

Palagini

, Moretto

, Novi

, Masci

, Caruso

, Drake

C. L.

, & Riemann

(2018). Lack of resilience is related to stress-related sleep reactivity, hyperarousal, and emotion dysregulation in insomnia disorder. Journal of Clinical Sleep Medicine, 14, 759–766. https://doi.org/10.5664/jcsm.7100.

Seow

L. S. E.

, Verma

S. K.

, Mok

Y. M.

, Kumar

, Chang

, Satghare

, Hombali

, Vaingankar

, Chong

S. A.

, & Subramaniam

(2018). Evaluating DSM-V insomnia disorder and the treatment of sleep problems in a psychiatric population. Journal of Clinical Sleep Medicine, 14, 237–244. https://doi.org/10.5664/jcsm.6942.

10.

Silversten

, Hysing

, Harvey

A. G.

, & Petrie

K. J.

(2021). The epidemiology of insomnia and sleep duration across mental and physical health: The SHoT Study. Frontiers in Psychology, 14, 2021. https://doi.org/10.3389/fpsyg.2021.662572.eCollection.

11.

Suni

(2021). Sleep diary. Sleep Foundation. https://www.sleepfoundation.org/sleep-diary.

12.

Waler

W. H.

, Walton

J. C.

, Devries

A. C.

, & Nelson

R. J.

, (2020). Circadian rhythm disruption and mental health. Translational Psychiatry, 10, 28. https://doi.org/10.1038/s41398-020-0694-0.

13.

Ypsilanti

, Lazuras

, Robson

, & Akram

(2018). Anxiety and depression mediate the relationship between self-disgust and insomnia disorder. Sleep Health, 4, 349–351. https://doi.org/10.1016/j.sleh.2018.06.001.