Doctorate in Clinical Psychology: Main Research Portfolio

: 1) Psychological and Psychosocial Interventions for Insomnia in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis; 2) An Exploration of Staff Attitudes Towards Key-Working in a Child and Adolescent Mental Health Inpatient Unit: Thematic Analysis; 3) Single-Session Digital Cognitive Behavioural Therapy for Insomnia (CBTi) in University Students: A Feasibility Randomised Controlled Trial.

Abstract

Critical Review of the Literature. Psychological and Psychosocial Interventions for Sleep Problems in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis

Background and objective: Sleep disorders are common in people with Multiple Sclerosis (MS) but are often underdiagnosed and the evidence base for interventions is limited. This review aims to summarise and examine the existing literature for psychological and psychosocial interventions for sleep problems in people with MS, excluding diet and exercise-based interventions. Psychological and psychosocial interventions include psychotherapy, education and relaxation-based intervention.

Design: Systematic review and meta-analysis of RCTs and controlled trials.

Data sources: Cochrane CENTRAL library, APA psychnet (including Psycinfo), Pubmed, Embase, and Clinicaltrials.gov. Reference lists of included studies were searched for further references and study authors were contacted to provide additional data.

Eligibility criteria for selecting studies: RCTs or controlled trials of nonpharmacological interventions with adults with a diagnosis of MS that included a valid and reliable measure of sleep as a primary or secondary outcome.

Results: Ten studies met criteria for inclusion in the review, comparing a total of 763 participants across 10 comparisons Most studies (8) reported some beneficial effect of intervention on sleep scores when compared to controls. Seven studies met criteria for inclusion in a meta-analysis comparing any non-pharmacological intervention to a control and this showed evidence in favour of intervention (SMD 1.17, 95% CI -1.94, -0.41; N = 524). A sub-set of three studies comparing CBT interventions with control were also included in a separate meta-analysis which also showed evidence in favour of intervention (SMD = -1.83, 95% CI -3.19, -0.47; N = 118). However, sample sizes of included studies were small and there was high heterogeneity of studies in both these analyses.

Conclusions: The evidence base is limited but indicates the potential benefits of non-pharmacological interventions for sleep problems in people with MS. Given the impact that sleep problems have on quality of life and interaction with other symptoms, this merits further investigation.

Date of Award	15 Sept 2021
Original language	English
Awarding Institution	University of Bath
Supervisor	Pamela Jacobsen (Supervisor) & Gemma Taylor (Supervisor)