Tag Archives: insomnia

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CaHRU sleep research cited in UK parliamentary briefings on Sleep and Health

Sleep and healthResearch from CaHRU was cited in the recently published parliamentary briefing on Sleep and Health and Sleep and Long-term Health. The briefing was issued as a POSTnote from the Parliamentary Office of Science and Technology and cited CAHRU’s work on primary care for insomnia including the Resources for Effective Sleep Treatment (REST) website. Professor Graham Law and Niro Siriwardena met with one of the co-authors Lev Tankelevitch earlier this year to discuss their work.

Sleep and longterm healthThe briefing on Sleep and Health also cites two systematic reviews led by CaHRU’s Dr Coral Sirdifield on patient and general practitioner (GP) perceptions of the problems of benzodiazepine sleeping pills, an article by Prof Siriwardena providing guidance for GPs, and the OASIS trial (led by Prof Dan Freeman of Oxford University) showing the effects of treatment using digital Cognitive Behavioural Therapy for Insomnia (dCBTi) on psychiatric symptoms. The briefing on Sleep and Long-term Health  research papers on sleep assessment and the DIALS trial showing the effect of dCBTI on quality of life which is due for publication this autumn.

rest-logoThe REST project is also explicitly mentioned: ‘One strategy to improve training for healthcare professionals is through online training developed by the Resources for Effective Sleep Treatment project’ and the REST e-learning programme for GPs and healthcare staff has been accessed over 16,000 times by users in over 160 countries.

POSTnotes are distributed in paper copies to Parliamentarians, placed in the reference libraries of both Houses of Parliament and also promoted via social media using Twitter @POST_UK. CaHRU are currently collaborating in a major trial of sleep restriction therapy in primary care, the HABIT trial. You can find out more about our work on sleep from our infographic on ‘Sleep and Insomnia‘.

By Prof Niro Siriwardena

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CaHRU presents research on sleep at college summer showcase

BrayfordThe annual research showcase, featuring speakers from the College of Social Science took place on 6 June 2018. Professor Niro Siriwardena presented on CaHRU’s work on sleep. Sleep is fundamental to our wellbeing, from birth to old age. Poor sleep affects health, sickness, life, death, productivity, and the wider economy. Sleep is as important to health as other lifestyle factors such as diet and exercise but, compared to these, is under-researched and under-invested in. There are effective psychological treatments for insomnia but these are not widely available, whereas less effective and potentially harmful drug treatments are commonly used.

CSSsummershowcase2He described the work of members of CaHRU together with partners at the University of Lincoln and other academic institutions (Oxford, Manchester, Glasgow, Ghent), in partnership with service users, staff and healthcare organisations, locally, nationally and internationally. Over the past 15 years, using systematic reviews, observational and qualitative studies, quasi-experiments and trials, staff in CaHRU have explored the problem of primary care for sleep, how this might be improved, and what effect this is having on sleep, prescribing, and health outcomes.

INB2The work has led to a major multicentre trial, funded by the National Institute for Health Research (£1.8M), investigating the effectiveness and cost-effectiveness of sleep restriction therapy, a behavioural treatment for insomnia, delivered in primary care. These studies and the wider impacts of this work were presented to those present.

 

[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2018/07/Sleep_Siriwardena.pdf” width=”660″]Multi-morbidity, goal-oriented care, the community and equity[/su_document]

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CaHRU contributes to Research and Innovation conference

elcock_lpft Professor Niro Siriwardena was a keynote speaker at Lincolnshire Partnership NHS Foundation Trust’s (LPFT) Research and Innovation Conference which took place at Branston Hall on 8 March 2018. The conference was chaired by Dr Sue Elcock, medical director at LPFT. The event, which was attended by over 100 delegates, included keynote talks from Chris Roberts, Alzheimer’s Society Ambassador, Professor Belinda Lennox of the University of Oxford and Dr Joanna Moncrieff of University College London.

chrisroberts_lpftChris Roberts, who himself has dementia and his wife, Jayne Goodrick spoke on ‘Join dementia research ‘handing out hope’ and the importance of those with the condition and their families engaging with studies into the condition as a means of providing possibilities for future treatment and care. Professor Cox spoke on her ground-breaking work on psychosis and immunity on ‘Could psychosis be a treatable immune disorder?’ This was followed by workshops on ‘How to make a first step into a clinical academic career’, ‘Taking a stab at research’, ‘How research improved practice’ and ‘Falls prevention in care homes’.

 

niro_lpftAfter lunch there followed LPFT’s innovation bid winners and how they had developed their ideas. Another example of ‘How to develop your ideas into research’ and the importance of collaboration between the NHS and the University of Lincoln was presented by Dr Amulya Nadkarni (consultant in child and adolescent mental health), Sophie Keogh (undertaking a research secondment at the Lincoln Institute for Health), Prof Siriwardena of CaHRU. They discussed how the collaboration began, how the ideas for research emerged, progress on current work on a systematic review of ‘Effects of non-pharmacological interventions for insomnia in children with Autistic Spectrum Condition, and how this was planned to lead to future work.

The final talk was from Dr Moncrieff on ‘Get involved – research into reducing or stopping antipsychotic medication’, how drugs could we withdrawn in some patients on these drugs and the programme of research which included a randomised controlled trial of antipsychotic withdrawal.

By Prof Niro Siriwardena

 

 

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CaHRU/LIH seminar: Quality Improvement Collaboratives – theory design and effects

CaHRU_logotypeThe latest in the CaHRU and Lincoln Institute for Health Improvement Science and Research Methods seminar series was given by Professor Siriwardena on ‘Quality Improvement Collaboratives (QICs): theory design and effects on 28 February 2018. The CaHRU team have led three large scale collaboratives over the past 12 years, including Resources for Effective Sleep Treatment (REST), the Ambulance Services Cardiovascular Quality Initiative (ASCQI) and most recently Scaling up PINCER (a pharmacist and information technology intervention to reduce potential clinically important prescribing errors in general practice.

niro2QICs are an organised, multifaceted approach to quality improvement involving five essential features: a specified topic; clinical experts and experts in quality improvement provide ideas and support for improvement; multi-professional teams from multiple sites participate; using a model for improvement (measurement, change, feedback); and a collaborative process involves series of structured activities. The talk described how QICs have been used to implement healthcare interventions at scale and referred to a recent systematic review suggesting that over 4 out of 5 reported improvement in one or more outcomes although the quality of studies was variably poor.

QICs were described in terms of their common features: a logic model and theory of change; the complex (pragmatic) contexts of the intervention, setting and participants; and the variation in effects and changes that the intervention can or will undergo during the process of the collaborative. It was proposed that there were different types of collaborative based on their purpose which could be for intervention development, increasing reliability of evidence based processes, or scaling up evidence based complex interventions. It was argued that reviews of QICs should consider these different purposes when describing the outcomes and effects of QICs.

By Professor Niro Siriwardena[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2018/03/QICs_Siriwardena.pdf” width=”660″ responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]

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CaHRU brings together Lincoln sleep researchers for LIH seminar

Professor Niro Siriwardena led the recent Lincoln Institute for Health (LIH) research development seminar entitled, ‘Things that go bump in the night’: exploring the problem of tinnitus and sleep.

This seminar brought together researchers at the University of Lincoln with a common interest in sleep research to explore interdisciplinary research into insomnia. Several research centres, groups and experts from a number of disciplines are members of the LIH and each have a record of funded studies investigating sleep and insomnia in a variety of conditions. The work builds on the University of Lincoln’s 4* impact case study on insomnia from REF2014.

 

The seminar focused on how to combine different research approaches to explore how the team might improve the management of insomnia linked to tinnitus. This began with presentations from each participant on their experience and current work in this field:

  • Niro, who is professor of primary and prehospital care, began by describing CaHRU’s translational research focus, seeking to improve health care processes and outcomes. A key area has been in primary care for people with insomnia which includes systematic reviews, qualitative studies and the development and evaluation of psychological interventions for insomnia.
  • WordItOut-word-cloud-2565244Prof Alina Rodriguez, professor in psychology, presented her approach combining methodological strategies including psychological, epidemiological, and molecular to understand the development of behavioural, cognitive, emotional or physical problems across the lifespan, seeking to identify factors amenable to change that can be translated into public health policy or interventions.
  • Prof Graham Law is professor in medical statistics and has worked extensively in epidemiology and medical statistics, focussing on sleep and the consequences of good and poor sleep on metabolic and cardiovascular health.
  • Dr Simon Durrant, senior lecturer in psychology, initially trained as a musician (counter tenor) before developing his expertise in the cognitive neuroscience of sleep. He leads the sleep lab at Lincoln using techniques such as polysomnography, EEG and actigraphy to understand the physiological basis of sleep and its disorders.

The group then discussed, together and with other academics present, the problem of tinnitus (noise generated internally in the body) which affects around 10% of adults and is associated with insomnia in over three-quarters of those with the condition, particularly causing difficulty getting off to sleep (so-called sleep latency). There followed an exploration of potential ways to investigate the problem of insomnia linked to tinnitus (e.g. using evidence synthesis, analysis of large datasets, and qualitative designs) together with the potential for intervention develop (e.g. using CBT for insomnia together with CBT for tinnitus) and evaluation of these.

The seminar ended with suggestions and proposals for how to take this work forward.

[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2017/11/Tinnitus_insomnia_finalrevised.pdf” responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]

A. N. Siriwardena