The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis

Freeman, Daniel; Sheaves, Bryony; Goodwin, Guy M.; Yu, Ly-Mee; Nickless, Alecia; Harrison, Paul J.; Emsley, Richard; Luik, Annemarie I.; Foster, Russell G.; Wadekar, Vanashree; Hinds, Christopher; Gumley, Andrew; Jones, Ray; Lightman, Stafford; Jones, Steve; Bentall, Richard; Kinderman, Peter; Rowse, Georgina; Brugha, Traolach; Blagrove, Mark; Gregory, Alice M.; Fleming, Leanne; Walklet, Elaine; Glazebrook, Cris; Davies, E. Bethan; Hollis, Chris; Haddock, Gillian; John, Bev; Coulson, Mark; Fowler, David; Pugh, Katherine; Cape, John; Moseley, Peter; Brown, Gary; Hughes, Claire; Obonsawin, Marc; Coker, Sian; Watkins, Edward; Schwannauer, Matthias; MacMahon, Kenneth; Siriwardena, A. Niroshan; Espie, Colin A.

Abstract

Background

Sleep difficulties might be a contributory causal factor in the occurrence of mental health problems. If this is true, improving sleep should benefit psychological health. We aimed to determine whether treating insomnia leads to a reduction in paranoia and hallucinations.

Methods

We did this single-blind, randomised controlled trial (OASIS) at 26 UK universities. University students with insomnia were randomly assigned (1:1) with simple randomisation to receive digital cognitive behavioural therapy (CBT) for insomnia or usual care, and the research team were masked to the treatment. Online assessments took place at weeks 0, 3, 10 (end of therapy), and 22. The primary outcome measures were for insomnia, paranoia, and hallucinatory experiences. We did intention-to-treat analyses. The trial is registered with the ISRCTN registry, number ISRCTN61272251.

Findings

Between March 5, 2015, and Feb 17, 2016, we randomly assigned 3755 participants to receive digital CBT for insomnia (n=1891) or usual practice (n=1864). Compared with usual practice, the sleep intervention at 10 weeks reduced insomnia (adjusted difference 4·78, 95% CI 4·29 to 5·26, Cohen's d=1·11; p

Citation

Freeman, D., Sheaves, B., Goodwin, G. M., Yu, L.-M., Nickless, A., Harrison, P. J., Emsley, R., Luik, A. I., Foster, R. G., Wadekar, V., Hinds, C., Gumley, A., Jones, R., Lightman, S., Jones, S., Bentall, R., Kinderman, P., Rowse, G., Brugha, T., Blagrove, M., …Espie, C. A. (2017). The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis. Lancet Psychiatry, 4(10), 749-758. https://doi.org/10.1016/S2215-0366%2817%2930328-0

• Journal Article Type: Article
• Acceptance Date: Sep 6, 2017
• Online Publication Date: Sep 6, 2017
• Publication Date: Sep 6, 2017
• Deposit Date: Dec 11, 2018
• Publicly Available Date: Dec 12, 2018
• Print ISSN: 2215-0366
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 4
• Issue: 10
• Pages: 749-758
• DOI: https://doi.org/10.1016/S2215-0366%2817%2930328-0
• Public URL: https://nottingham-repository.worktribe.com/output/1221769
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S2215036617303280
• Contract Date: Dec 11, 2018