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Effect of Sleep Skills Education on Sleep Quality in Patients Attending a Psychiatry Partial Hospitalization Program

Imran S. Khawaja, MD; Michael E. Dieperink, MD; Paul Thuras, PhD; Ken M. Kunisaki, MD; Marianne M. Schumacher, PhD; Anne Germain, PhD; Becky Amborn, RN; and Thomas D. Hurwitz, MD

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ABSTRACT

Objective: To evaluate the effectiveness of cognitive-behavioral therapy for insomnia (CBT-I)–informed sleep skills education on sleep quality and initial sleep latency in patients attending a psychiatry partial hospitalization program.

Method: This retrospective chart review was conducted in a psychiatry partial hospitalization program of a teaching Veterans Affairs medical center located in Minneapolis, Minnesota. Patients typically attend the program for 1 month. Data were collected from a continuous improvement project from November 2007 to March 2009. The Pittsburgh Sleep Quality Index (PSQI) was administered to the patients at the time of entry into the program and at their discharge. Patients who completed both PSQI assessments were included in the study.

Results: A total of 183 patients completed both PSQI assessments. Of those, 106 patients attended CBT-I–informed sleep skills education and 77 did not (all patients completed the psychiatry partial hospitalization program). For all patients, the mean ± SD baseline PSQI score was 12.5 ± 4.8. PSQI scores improved by a mean of 3.14 points (95% CI, 2.5–3.8; P < .001) in all patients who completed the psychiatry partial hospitalization program. For all patients, there were significant reductions in sleep latency (17.6 minutes) (t183 = 6.58, P < .001) and significant increases in overall sleep time, from 6.1 to 6.7 hours (t183 = 4.72, P < .001). There was no statistically significant difference in PSQI scores of patients who attended CBT-I–informed sleep skills education and those who did not during their stay in the partial hospitalization program.

Conclusions: The quality of sleep and initial sleep latency improved in patients who completed the psychiatry partial hospitalization program regardless of whether they attended CBT-I–informed sleep skills education or not. In this study, a structured psychiatry partial hospitalization program improved perceived sleep quality and initial sleep latency. Additional randomized controlled trials with a higher intensity of CBT-I–informed sleep skills education are needed.

Prim Care Companion CNS Disord 2013;15(1):doi:10.4088/PCC.12m01440

Submitted: July 13, 2012; accepted November 19, 2012.

Published online: February 14, 2013.

Corresponding author: Imran S. Khawaja, MD, One Veteran’s Drive, Minneapolis, MN 55417 (khimran@yahoo.com).