16th November 2011, 6:32pm
Inside insomnia: Lincoln research on the Tonight programme ITV1
The Tonight logo © Copyright ITV plc 2011 Research identifying better care for sufferers with insomnia and sleep problems involving offering alternatives to sleeping pills, led by the University of Lincoln in partnership with NHS Lincolnshire, features in the Tonight programme on ITV1 on Thursday 17 November.

In the programme Geraint Vincent reports on the condition, revealing some results of the Great British Sleep Survey and finding out from sufferers how it affects their lives.

The research project, Resources for Effective Sleep Treatment (REST), aimed to understand and improve the primary care management of insomnia and enable patients to access better sleep assessment and treatment in general practice. Insomnia contributes to daytime tiredness, which in turn can lead to accidents, illness and work and relationship problems.

Professor of Primary and Pre-hospital Health Care at the University of Lincoln and part-time general practitioner, Niroshan Siriwardena, led the study. He said: “Almost everyone has difficulty sleeping at some point in their life but in most cases this is short term. However, around one in ten people suffer from chronic insomnia, which occurs on a regular basis or over a long period of time. It is most commonly caused by stress and worry but can also be triggered by pain, noise, medication, depression and shift-work.”

The study aimed to identify better assessment for sleep problems and psychological treatments for insomnia and adapt these for use in general practice. GPs could then offer patients treatment options, which were more in line with what patients actually needed. Some of the psychological treatments used as part of cognitive behavioural therapy for insomnia (CBTi) include cognitive techniques to help people understand sleep better and think about it differently as well as behavioural therapies including sleep hygiene, stimulus control, muscle relaxation and sleep restriction. Another benefit was a reduction in inappropriate prescribing, potential harm to patients, and unnecessary costs to the NHS.

Over three years the research project surveyed 1,000 patients and 40 practices in Lincolnshire. Nine out of ten patients were on a repeat prescription that had been started by their GP. About two thirds took it every night (which can lead to addiction) and half had side effects such as headache, dizziness and nausea. One fifth of the patients wanted to stop their tablets and at least half of the patients said they had tried to come off treatment.

“We also interviewed patients to find out what they needed, and GPs and nurses to see how care could be improved,” said Professor Siriwardena. “We developed, together with GPs and nurses involved in the study, a patient focused approach which included detailed sleep assessment and CBTi.”

The study team included: Michelle Tilling, REST Project Manager; Andrew Harrison
Patient champion on REST project; Fiona Togher, University of Lincoln; Dr Jane Dyas, Primary Care Lead, NIHR Research Design Service East Midlands; Dr Roderick Orner, Consultant Clinical Psychologist, Visiting Professor in Clinical Psychology, Faculty of Health, Life and Social Sciences, University of Lincoln; Dr Zubair Qureshi, General Practitioner, South Park Surgery, Lincoln; Dr Hugh Middleton, University of Nottingham; Professor Michael Dewey, Professor of Health Service and Population Research, Institute of Psychiatry, Kings College London; Dr Tracey Sach, Senior Lecturer Health Economics, University of East Anglia; Dr Casey Quinn, Lecturer Health Economics, University of Nottingham; Jane Christmas, Head of Integrated Governance and Risk, NHS Lincolnshire.

The study was funded by the Health Foundation under their Engaging with Quality in Primary Care scheme and is now being extended through the East Midlands Health Innovation Educational Cluster (EMHIEC).

The team is working on a number of other studies including ENACT (Exploring social Networks to Augment Cognitive behavioural Therapy). Together with Professor Shaun Lawson and colleagues from Loughborough and Sussex Universities the ENACT study is researching a new form of computerised CBTi.

Further work is also planned at the University of Lincoln together with Dr Simon Durrant who is leading a new sleep lab.  

ITV 1's Tonight programme has consistently been the highest rating current affairs series on UK television for the past decade. It remains ITV's flagship current affairs strand and has built an enviable reputation for airing the most significant interviews and handling key and often delicate issues. The programme has secured countless exclusive interviews over the years with world leaders, eminent scientists, sporting heroes and royalty. View the episode: Waking up to insomnia
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