The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index; 4 of the 34 sources its claims cite were checked for support.
The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis
Open accessAbstract
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<0·0001), paranoia (-2·22, -2·98 to -1·45, Cohen's d=0·19; p<0·0001), and hallucinations (-1·58, -1·98 to -1·18, Cohen's d=0·24; p<0·0001). Insomnia was a mediator of change in paranoia and hallucinations. No adverse events were reported. INTERPRETATION: To our knowledge, this is the largest randomised controlled trial of a psychological intervention for a mental health problem. It provides strong evidence that insomnia is a causal factor in the occurrence of psychotic experiences and other mental health problems. Whether the results generalise beyond a student population requires testing. The treatment of disrupted sleep might require a higher priority in mental health provision. FUNDING: Wellcome Trust.
Overview
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Written from the paper’s full text.
TL;DR
In the OASIS trial, digital CBT for insomnia in university students reduced insomnia and produced small sustained reductions in paranoia and hallucinations compared with usual practice. Mediation analyses suggested that improvements in insomnia accounted for a substantial portion of the reductions in psychotic experiences.
Key findings
- Among 3755 randomised participants (digital CBT n=1891; usual practice n=1864), at 10 weeks the intervention reduced insomnia (adjusted difference 4·78, 95% CI 4·29–5·26, Cohen’s d=1·11), paranoia (−2·22, −2·98 to −1·45, d=0·19), and hallucinations (−1·58, −1·98 to −1·18, d=0·24); all p<0·0001.
- Insomnia mediated change in psychotic experiences: week 3 insomnia explained 29·5% of the paranoia effect and 20·7% of the hallucination effect at week 10; week 10 insomnia explained 57·8% and 38·6%, respectively. Reverse-direction mediation was much smaller (paranoia 3·8%; hallucinations 3·4%).
- Secondary outcomes improved for depression, anxiety, prodromal symptoms, nightmares, psychological wellbeing, and functioning, and participants were less likely to meet criteria for depressive episode, anxiety disorder, or ultra-high risk of psychosis. However, mania symptoms increased and risk of meeting criteria for a manic episode was greater; no adverse events were reported.
Methods
- Single-blind, randomised controlled trial at 26 UK universities. Participants were university students aged 18 or older with a positive insomnia screen (SCI score ≤16) and no exclusion criteria; recruitment ran March 5, 2015, to Feb 17, 2016.
- Participants were randomly assigned 1:1 via simple randomisation to digital CBT for insomnia (Sleepio) or usual practice, with online assessments at weeks 0, 3, 10, and 22. Primary outcomes were insomnia (SCI-8), paranoia (GPTS part B), and hallucinations (SPEQ hallucinations subscale).
- Intention-to-treat analyses used linear mixed effects models with time, randomised group, baseline score, sex, and course level as fixed effects and random effects for students nested within universities. Mediation used a Baron-and-Kenny-like approach with linear mixed effects models.
Limitations
- The paper states: reliance on self-report questionnaires; samples were predominantly in the non-clinical range of psychotic experiences; participants were self-selecting; generalisability beyond students is unknown; high dropout, especially in the treatment group, may bias results; and mediation cannot fully capture temporal order or rule out reverse causation.
- The text also makes evident that treatment uptake was low: 69% logged on for at least one session and 18% accessed all six sessions, with treatment effects greater among completers.
- The paper reports no adverse events, but also reports increased mania symptoms and greater risk of meeting manic episode criteria with the sleep treatment, which it discusses as possibly reflecting increased wellbeing or problematic manic symptoms.
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Claims the paper makes
39 Own result · 28 Own method · 21 Not checked yet · 21 Own interpretation · 2 Supported so far · 2 No basis given · 1 Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“A clinical cutoff of less than 17 correctly identifies 89% of individuals with probable insomnia disorder.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Methods > Outcomes
What the sources say
- Supportedcites [16] Espie, 2014, The sleep condition indicator: a clinical screening tool to evaluate insomnia disorder, BMJ Open source
The Results (Development of the SCI) report that an SCI cutoff of ≤16 correctly identified 89% of the sample classified as having probable insomnia disorder by ISI score. Because SCI scores are integers, ≤16 is equivalent to less than 17. The paper notes that this was a comparison with ISI cutoffs, not an independent clinical diagnosis. (LLM, conf=0.93)
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“The large treatment reduction in insomnia for the students is very similar to that found in trials with general adult populations,10, 11, 36”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
What the sources say
- Not checked yetcites [10] Ritterband, 2017, Effect of a web-based cognitive behaviour therapy for insomnia intervention with a 1-year follow-up: a randomized clinical trial, JAMA Psychiatry source
- Supportedcites [11] Espie, 2012, A randomized, placebo-controlled trial of online cognitive behavioral therapy for chronic insomnia disorder delivered via an automated media-rich web application, Sleep source
The Results describe a trial of 164 adults aged 18–78, and the Discussion reports large treatment effects on sleep efficiency and substantial reductions in sleep-onset latency and wake time after sleep onset. This supports the cited paper’s role as a general-adult trial showing a large reduction in insomnia; the comparison with students is the citing authors’ own. (LLM, conf=0.90)
- Not checked yetcites [36] Zachariae, 2016, Efficacy of internet-delivered cognitive-behavioral therapy for insomnia— a systematic review and meta-analysis of randomized controlled trials, Sleep Med Rev source
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Insomnia was a mediator of change in paranoia and hallucinations.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Abstract > Findings
plaindirectn = 3,755- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Insomnia was a mediator of change in paranoia and hallucinations.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Abstract > Findings
plaindirectn = 3,755- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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<0·0001), paranoia (−2·22, −2·98 to −1·45, Cohen's d=0·19; p<0·0001), and hallucinations (−1·58, −1·98 to −1·18, Cohen's d=0·24; p<0·0001).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Abstract > Findings
plaindirectn = 3,755 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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<0·0001), paranoia (−2·22, −2·98 to −1·45, Cohen's d=0·19; p<0·0001), and hallucinations (−1·58, −1·98 to −1·18, Cohen's d=0·24; p<0·0001).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Abstract > Findings
plaindirectn = 3,755 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No adverse events were reported.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Abstract > Findings
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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<0·0001), paranoia (−2·22, −2·98 to −1·45, Cohen's d=0·19; p<0·0001), and hallucinations (−1·58, −1·98 to −1·18, Cohen's d=0·24; p<0·0001).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Abstract > Findings
plaindirectn = 1,891 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Abstract > Findings
plainn = 3,755- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“After treatment, 454 (62%) of 733 individuals in the treatment group and 326 (29%) of 1142 individuals in the control group scored outside the clinical cutoff for insomnia used for trial entry.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plainn = 733- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The large improvement in insomnia is confirmed with the ISI assessment (table 4).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The reduction in insomnia after treatment was large, while the reduction in psychotic experiences was small (table 2).”
- Also stated in: § Discussion · plain
“A large effect size reduction was found with the digital CBT intervention in a large student population.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirectn = 733- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“change in sleep over 3 weeks explained 30% of the intervention effect on paranoia at 10 weeks”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The sleep treatment also led to improvements in depression, and improvements in anxiety, prodromal symptoms, nightmares, psychological wellbeing, and functioning, and all these improvements were maintained over time (Table 4, Table 5).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirectn = 1,718- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the sleep treatment was associated with significant reductions, at all timepoints, in insomnia, paranoia, and hallucinations compared with the control group (all p<0·0001; table 2)”
- Also stated in: § Discussion · plain
“Students randomly assigned to the sleep intervention showed small, sustained reductions in paranoia and hallucinations”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Change in sleep over 3 weeks explained 21% of the intervention effect on hallucinations at 10 weeks”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The reduction in insomnia after treatment was large, while the reduction in psychotic experiences was small (table 2).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The sleep treatment also led to improvements in depression, and improvements in anxiety, prodromal symptoms, nightmares, psychological wellbeing, and functioning, and all these improvements were maintained over time (Table 4, Table 5).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, contact with mental health services did not differ between groups (table 5).”
- Also stated in: § Discussion · plain
“sleep treatment did not affect contact with mental health services”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plainn = 1,718- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Those participants randomised to the sleep treatment were also less likely to meet criteria over the course of the trial for a depressive episode, anxiety disorder, or ultra-high risk of psychosis (table 5).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“when paranoia and hallucination outcomes at 3 weeks were set as the mediators and the sleep outcome at 10 weeks as the main outcome, paranoia symptoms mediated just 3·8% of change in sleep”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The sleep treatment also led to improvements in depression, and improvements in anxiety, prodromal symptoms, nightmares, psychological wellbeing, and functioning, and all these improvements were maintained over time (Table 4, Table 5).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Those participants randomised to the sleep treatment were also less likely to meet criteria over the course of the trial for a depressive episode, anxiety disorder, or ultra-high risk of psychosis (table 5).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and hallucinations mediated 3·4% of change in sleep.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, the sleep treatment led to a small, sustained increase in symptoms of mania (table 5).”
- Also stated in: § Discussion · plain
“manic symptoms associated with the sleep treatment increased”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“with change in sleep over 10 weeks accounting for 39% of the intervention effect on hallucinations.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The sleep treatment also led to improvements in depression, and improvements in anxiety, prodromal symptoms, nightmares, psychological wellbeing, and functioning, and all these improvements were maintained over time (Table 4, Table 5).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirectn = 1,718- Asserted: passes — The authors put it forward as true.
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In the paper
“At baseline, the frequency of positive screens for psychosis risk with the Prodromal Questionnaire was high, similar to the risk found with this questionnaire for adolescents referred to treatment services;34”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
What the sources say
- Not checked yetcites [34] De Jong, 2016, Screening for psychosis risk among adolescents in Child and Adolescent Mental Health Services: a description of the first step with the 16-item version of the Prodromal Questionnaire (PQ-16), Early Interv Psychiatry source
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The sleep treatment also led to improvements in depression, and improvements in anxiety, prodromal symptoms, nightmares, psychological wellbeing, and functioning, and all these improvements were maintained over time (Table 4, Table 5).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“with change in sleep over 10 weeks accounting for 58% of the treatment effect on paranoia (table 3)”
- Also stated in: § Discussion · plain
“improvements in sleep accounted for almost 60% of the change in paranoia after treatment”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the sleep treatment was associated with significant reductions, at all timepoints, in insomnia, paranoia, and hallucinations compared with the control group (all p<0·0001; table 2)”
- Also stated in: § Discussion · plain
“Students randomly assigned to the sleep intervention showed small, sustained reductions in paranoia and hallucinations”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“With the sleep treatment, a greater risk also existed of meeting criteria for a manic episode (table 5).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The sleep treatment also led to improvements in depression, and improvements in anxiety, prodromal symptoms, nightmares, psychological wellbeing, and functioning, and all these improvements were maintained over time (Table 4, Table 5).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the sleep treatment was associated with significant reductions, at all timepoints, in insomnia, paranoia, and hallucinations compared with the control group (all p<0·0001; table 2)”
- Also stated in: § Discussion · plain
“The first necessary stage was for the intervention to reduce insomnia, which was achieved.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Those participants randomised to the sleep treatment were also less likely to meet criteria over the course of the trial for a depressive episode, anxiety disorder, or ultra-high risk of psychosis (table 5).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“while evidence for reverse causation was weak”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“but it is notable that treatment effects were greater for those participants who completed the sleep treatment.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The association of insomnia with psychotic experiences in the general population has been established.3”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Introduction
What the sources say
- Not checked yetcites [3] Reeve, 2015, The role of sleep dysfunction in the occurrence of delusions and hallucinations, Clin Psychol Rev source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It shows very clearly that treatment of insomnia in students leads to a reduction in psychotic experiences.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Introduction
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Paranoia and hallucinations have the strongest links with insomnia.2, 7, 8”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Introduction
What the sources say
- Not checked yetcites [2] Freeman, 2009, Insomnia and paranoia, Schizophr Res source
- Not checked yetcites [7] Taylor, 2015, Do sleep disturbances and psychotic experiences in adolescence share genetic and environmental influences?, J Abnorm Psychol source
- Not checked yetcites [8] Sheaves, 2016, Insomnia, nightmares and chronotype as markers of risk for severe mental illness, Sleep source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In patients with current delusions and hallucinations, results of our pilot randomised controlled trial13 have shown that insomnia can be substantially reduced with CBT”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Introduction
What the sources say
- Not checked yetcites [13] Freeman, 2015, Efficacy of cognitive behavioural therapy for sleep improvement in patients with persistent delusions and hallucinations (BEST): a prospective, assessor-blind, randomised controlled pilot study, Lancet Psychiatry source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It provides strong evidence that insomnia is a causal factor in the occurrence of psychotic experiences and other mental health problems.”
- Also stated in: § Introduction · hedged
“Sleep disruption might have a contributory causal role in the occurrence of psychotic experiences and a wide range of other mental health problems.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Abstract > Interpretation
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Introduction · hedged
In the paper
“but the trial was underpowered to establish with sufficient precision the consequences for psychotic experiences.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Introduction
What the sources say
- Not checked yetcites [13] Freeman, 2015, Efficacy of cognitive behavioural therapy for sleep improvement in patients with persistent delusions and hallucinations (BEST): a prospective, assessor-blind, randomised controlled pilot study, Lancet Psychiatry source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Based on the SDs observed from a previous study29 for the GPTS (SD 10·4), a total sample size of 2614 participants (ie, 1307 per group) would provide 90% power to detect a small effect size in paranoia, with a standardised mean difference of 0·15, while accounting for a high amount of expected attrition (40%).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Methods > Statistical analysis
What the sources say
- Not checked yetcites [29] Freeman, 2014, The use of intuitive and analytic reasoning styles by patients with persecutory delusions, J Behav Ther Exp Psychiatry source
hedgedn = 2,614- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is the first study adequately powered to determine the effects of treating sleep dysfunction on psychotic experiences.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Introduction
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The two randomised groups were well matched at baseline (table 1).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It provides strong evidence that insomnia is a causal factor in the occurrence of psychotic experiences and other mental health problems.”
- Also stated in: § Introduction · hedged
“Sleep disruption might have a contributory causal role in the occurrence of psychotic experiences and a wide range of other mental health problems.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Abstract > Interpretation
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Introduction · hedged
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These trials were underpowered to determine with any precision the potential link between insomnia and psychotic experiences.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Introduction
plaincorrelationaln = 50- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“To our knowledge, this is the largest randomised controlled trial of a psychological intervention for a mental health problem.”
- Also stated in: § Introduction · hedged
“We undertook what might be the largest randomised controlled trial to date of a psychological treatment.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Abstract > Interpretation
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
- Also stated in: § Introduction · hedged
None of the sources cited for this claim have been checked yet.
In the paper
“while previous studies36, 37 with community samples have shown self-help sleep treatment to reduce anxiety and depression.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
What the sources say
- Not checked yetcites [36] Zachariae, 2016, Efficacy of internet-delivered cognitive-behavioral therapy for insomnia— a systematic review and meta-analysis of randomized controlled trials, Sleep Med Rev source
- Not checked yetcites [37] van Straten, 2009, Self-help therapy for insomnia: a meta-analysis, Sleep Med Rev source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Hence, this study adds to our understanding of the causes of psychotic experiences and might indicate a promising route into the early treatment of some psychotic problems.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Even within the student population, we do not know the representativeness of the participants.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Treatment differences also remained consistent with the primary analysis when we repeated the main analyses covarying for baseline variables that predicted missingness for each outcome.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“All three primary outcome differences remained significant with last observation carried forward imputations (appendix 1).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“and was greater in the treatment group than in the control group”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The effects on anxiety and depression are consistent with the results of a meta-analysis.33”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
What the sources say
- Not checked yetcites [33] Ye, 2015, Internet-based cognitive behavioral therapy for insomnia (ICBT-i) improves comorbid anxiety and depression—a meta-analysis of randomized controlled trials, PLoS One source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The baseline scores for the three primary outcomes (insomnia, paranoia, and hallucinations) were not associated with later missingness (appendix 1).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We consider that the results are likely to apply to the wider adult population.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Treatment uptake was relatively low.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plainn = 1,302- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These outcomes lend further support to the causal pathway hypothesis proposed in this study.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Treatment differences would still be significant assuming the missing individuals in the treatment group had outcome scores 2 points worse for insomnia and paranoia, and 1 point worse for hallucinations”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Hence early changes in sleep explain approximately half of the total sleep-mediated changes in psychotic experiences by the end of treatment.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The dropout from the study assessments was high (50%) during the course of the study”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The treatment differences were robust to the three different types of sensitivity analyses for missing data (appendix 1).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“suggesting that disrupted sleep has a contributory causal role in the occurrence of these psychotic experiences in a specific population of young adults”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: The sleep treatment first changes the occurrence of insomnia.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The results did remain robust against conservative assumptions in the sensitivity analyses about those participants who dropped out”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Fifth, bias in the outcome results will have been introduced because of the high dropout rate, especially in the treatment group, which is similar to comparable online studies.12”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
What the sources say
- Not checked yetcites [12] Christensen, 2016, Effectiveness of an online insomnia program (SHUTi) for prevention of depressive episodes (the GoodNight Study): a randomised controlled trial, Lancet Psychiatry source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We were able to show a significant amount of mediation based on the week 3 insomnia score as a mediator, while evidence for reverse causation was weak, which does follow the predicted temporal causal pathway.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 16
- Probably not a substantial claim. 36
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“this high rate will reflect the well established associations of sleep difficulties with psychotic experiences2, 3, 7, 8 (ie, that participants have been selected for insomnia and therefore will score higher on psychosis measures), and also the limitations of brief self-report questionnaires for assessing psychosis risk.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
What the sources say
- Supportedcites [2] Freeman, 2009, Insomnia and paranoia, Schizophr Res source
The citation is attached to the association between sleep difficulties and psychotic experiences, not to the later point about brief screening questionnaires. The Discussion reports that higher insomnia levels were associated with higher persecutory-thinking levels, and the Results (Community group) report a strong association between insomnia scales and paranoia. The citing paper's explanation of its own baseline screening rate is consistent with that association. (LLM, conf=0.91)
- Supportedcites [3] Reeve, 2015, The role of sleep dysfunction in the occurrence of delusions and hallucinations, Clin Psychol Rev source
The Results (General population) describe a strong association between insomnia symptoms and psychotic experiences and conclude that there is strong evidence they co-occur. This supports the sleep–psychotic-experiences association to which the citation is attached; the explanation of the baseline screening rate and the comment about brief questionnaires are the citing authors’ own framing. (LLM, conf=0.91)
- Not checked yetcites [7] Taylor, 2015, Do sleep disturbances and psychotic experiences in adolescence share genetic and environmental influences?, J Abnorm Psychol source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“130 papers were identified and only two were randomised controlled trials that tested the effects of sleep treatment on psychotic experiences, with the larger of the trials being our own with 50 patients with schizophrenia or related disorders.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Introduction
plainn = 50- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The sample was predominately female, studying for their first university degree, and two-thirds were of white British ethnicity (table 1).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plainn = 3,755- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The sample was predominately female, studying for their first university degree, and two-thirds were of white British ethnicity (table 1).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plainn = 3,755- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Around a fifth of the participants were in contact with mental health services (table 1).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plainn = 3,755- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The sample was predominately female, studying for their first university degree, and two-thirds were of white British ethnicity (table 1).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plainn = 3,755- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The sleep treatment also led to improvements in depression, and improvements in anxiety, prodromal symptoms, nightmares, psychological wellbeing, and functioning, and all these improvements were maintained over time (Table 4, Table 5).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaindirectn = 1,718- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We did sensitivity analyses (pattern mixture models, inclusion of baseline covariates predictive of missing data, and imputation) for the three main outcomes, examining the robustness of the results to different assumptions regarding missing data.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Methods > Statistical analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Clinical guidelines recommend the use of cognitive behavioural therapy (CBT) as the first-line treatment for insomnia.9”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Introduction
What the sources say
- Not checked yetcites [9] Qaseem, 2016, Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians, Ann Intern Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“The effects of the manipulation can then be substantiated further by use of mediation analysis.5, 6”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Introduction
What the sources say
- Not checked yetcites [5] Dunn, 2015, Evaluation and validation of social and psychological markers in randomised trials of complex interventions in mental health: a methodological research programme, Health Technol Assess source
- Not checked yetcites [6] Emsley, 2010, Mediation and moderation of treatment effects in randomised controlled trials of complex interventions, Stat Methods Med Res source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The trial is registered with the ISRCTN registry, number ISRCTN61272251.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Abstract > Methods
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants completed all the assessments independently online and therefore their responses could not be affected by the trial team.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Methods > Randomisation and masking
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The internal consistency of the scale in the present study was 0·93.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Methods > Outcomes
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We confirmed the normality assumption of the residuals for each outcome. No deviations from normality were apparent and therefore maximum likelihood estimates were reported.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Methods > Statistical analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In a study amendment, the sample size was increased because of a higher than initially expected dropout rate.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Methods > Statistical analysis
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Each psychotic experience exists on a spectrum of severity in the general population with differing heritability and differing strength of association with insomnia.7”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Introduction
What the sources say
- Not checked yetcites [7] Taylor, 2015, Do sleep disturbances and psychotic experiences in adolescence share genetic and environmental influences?, J Abnorm Psychol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The interventionist–causal model approach to establishment of a causal association is to manipulate the hypothesised mechanistic variable and observe the effect on the outcome of interest;4”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Introduction
What the sources say
- Not checked yetcites [4] Kendler, 2009, Interventionist causal models in psychiatry: repositioning the mind-body problem, Psychol Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“if a causal association exists then the outcome variable should alter.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Introduction
What the sources say
- Not checked yetcites [4] Kendler, 2009, Interventionist causal models in psychiatry: repositioning the mind-body problem, Psychol Med source
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“As recommended for large clinical trials,17 we used simple randomisation (1:1) with an automated online system, ensuring that the research team was unable to affect randomisation.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Methods > Randomisation and masking
What the sources say
- Not checked yetcites [17] Hewitt, 2006, Is restricted randomisation necessary?, Br Med J source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“An outline of the analysis strategy was provided in the published trial protocol15 and a full statistical analysis plan was agreed before the trial analysis (appendix 2).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Methods > Statistical analysis
What the sources say
- Not checked yetcites [15] Freeman, 2015, Effects of cognitive behavioural therapy for insomnia on the mental health of university students, Trials source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Analyses were by intention to treat and were carried out at the end of the last follow-up assessment (with no interim analyses).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Methods > Statistical analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Digital forms of CBT for insomnia that require no therapist to be present have been shown to be efficacious as well.10, 11, 12”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Introduction
What the sources say
- Not checked yetcites [10] Ritterband, 2017, Effect of a web-based cognitive behaviour therapy for insomnia intervention with a 1-year follow-up: a randomized clinical trial, JAMA Psychiatry source
- Not checked yetcites [11] Espie, 2012, A randomized, placebo-controlled trial of online cognitive behavioral therapy for chronic insomnia disorder delivered via an automated media-rich web application, Sleep source
- Not checked yetcites [12] Christensen, 2016, Effectiveness of an online insomnia program (SHUTi) for prevention of depressive episodes (the GoodNight Study): a randomised controlled trial, Lancet Psychiatry source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, the trial is consistent with a small number of other randomised controlled trials that indicate multiple other benefits for mental health when treating sleep problems.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Introduction
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The internal consistency (Cronbach's α at baseline) of the scale in the present study was 0·63.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Methods > Outcomes
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The internal consistency of the scale in the present study was 0·94.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Methods > Outcomes
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“All the analyses were validated by a second statistician.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Methods > Statistical analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, the effect of altering the amount of sleep disruption—eg, by targeted sleep treatment—on these psychotic experiences remains to be established.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Introduction
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“This score is an 8-item measure, validated against DSM-5 criteria, assessing sleep and its impact on daytime functioning over the past week.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Methods > Outcomes
What the sources say
- Not checked yetcites [16] Espie, 2014, The sleep condition indicator: a clinical screening tool to evaluate insomnia disorder, BMJ Open source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“An alternative perspective is that disturbed sleep is a contributory causal factor in the occurrence of many mental health disorders.1”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Introduction
What the sources say
- Not checked yetcites [1] Harvey, 2011, Sleep disturbance as transdiagnostic: consideration of neurobiological mechanisms, Clin Psychol Rev source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“For the secondary measures, ISI, PHQ-9, Altman Mania Scale, and WSAS scores were slightly higher, and the WEMWBS score was slightly lower, in the missing groups than the non-missing groups (appendix 1).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Third, the participants were self-selecting in responding to the invitation, which will have affected the representativeness of the sample.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“No adverse events were reported to the trial team.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Compared with participants who remained in the study, participants who dropped out from both groups were younger in age and more likely to be male (appendix 1).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the trial does indicate that the provision of internet-delivered CBT for insomnia to university students is likely to lead to reductions overall in insomnia, and smaller reductions in a number of other mental health symptoms, with benefits for positive psychological wellbeing too.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Compared with participants who remained in the study, participants who dropped out from both groups were younger in age and more likely to be male (appendix 1).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“with this figure and pattern almost identical to the most comparable previous study.12”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
What the sources say
- Not checked yetcites [12] Christensen, 2016, Effectiveness of an online insomnia program (SHUTi) for prevention of depressive episodes (the GoodNight Study): a randomised controlled trial, Lancet Psychiatry source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Second, the samples tested were predominately in the non-clinical range of psychotic experiences, restricting the conclusions to the less severe end of the psychosis spectrum.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“First, the study relied on self-report questionnaires, albeit validated in their development against clinical interviews.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The Altman scale has been found to correlate poorly with self-ratings of elation.35”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
What the sources say
- Not checked yetcites [35] Tsanas, 2016, Daily longitudinal self-monitoring of mood variability in bipolar disorder and borderline personality disorder, J Affect Disord source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Fourth, the extent to which the results will generalise to the rest of the population is not known.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“For the secondary measures, ISI, PHQ-9, Altman Mania Scale, and WSAS scores were slightly higher, and the WEMWBS score was slightly lower, in the missing groups than the non-missing groups (appendix 1).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In the intervention group, 1302 participants (69%) logged on for at least one treatment session, 953 (50%) accessed at least two sessions, 672 (36%) accessed at least three sessions, 497 (26%) accessed at least four sessions, 390 (21%) accessed at least five sessions, and 331 (18%) accessed six sessions (figure).”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
plainn = 1,302- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Insomnia might not be the largest cause of psychotic experiences but it is not an epiphenomenon.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“but the mediation analyses in this trial based on week 10 outcomes cannot fully capture the temporal order of changes or rule out reverse causation.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Overall, this trial indicates the importance of sleep difficulties for mental health in the general population and the need for a reconsideration in clinical services of the priority given to improving sleep.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In reality, it is difficult in a clinical trial to capture potential temporal changes between mediator and outcomes, since improvements in paranoia and hallucinations are likely to closely parallel the improvement in sleep.”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Discussion
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
The paper relies on this without support.
Usual practice is likely to mean receiving little or no treatment.
“usual care, which is likely to mean receiving little or no treatment”
“The amount of treatment input was likely to be minimal, with prescription of medication for a small proportion.”
The authors state this as an assumption.
The data are missing at random.
“The method has the advantage of implicitly accounting for data missing at random.”
The paper relies on this without support.
There are multiple, independent psychotic experiences.
“There are multiple, independent, psychotic experiences.”
The authors state this as an assumption.
The sleep treatment first changes the occurrence of insomnia.
“the causal argument rests on the plausible assumption that the sleep treatment first changes the occurrence of insomnia, since that was the topic of the intervention”
The paper relies on this without support.
A gap exists in mental health services regarding intervention for early, relatively non-specific presentations.
“a gap exists in mental health services regarding intervention for early, relatively non-specific presentations”
The paper relies on this without support.
Young people with incipient disorders might be very reluctant to seek help for psychiatric problems.
“Young people with incipient disorders might be very reluctant to seek help for psychiatric problems.”
The paper relies on this without support.
Trouble sleeping is a common complaint with little stigma.
“Trouble sleeping is a common complaint with little stigma.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The Japanese version of the WSAS has good internal consistency and construct validity [31].”
From Translated and culturally adapted internet-delivered cognitive therapy for social anxiety disorder in Japanese clinical settings: study protocol for a randomised controlled trial (2024) · cites this paper as [31]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Additionally, a role of poor sleep in severe mental disorders is suggested by a recent RCT showing that cognitive behavioral therapy for insomnia (CBT-I) significantly reduces the severity of hallucinations and paranoia in youth experiencing symptoms of psychosis 95 .”
From A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders (2020) · cites this paper as [95]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“A different working group could have created a different needs analysis and chosen a different treatment focus, change methods and practical applications (see for example the CRISIS-, the WIT- or the OASIS-study) (150–152).”
From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [152]
The cited source says what the claim attributes to it.
In the citing paper
“Overall, poor sleep appears to play an important part in the onset and aggravation of mental illness, and CBT-I may provide an attractive non-pharmacological option (which can also be delivered digitally) for improving sleep and other aspects of mental health 94-96 .”
From A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders (2020) · cites this paper as [95]
In the citing paper
“treating insomnia improves psychotic experiences (Freeman et al., 2017)”
From Sleep duration and psychotic experiences in patients at risk of psychosis: a secondary analysis of the EDIE-2 trial (2019) · cites this paper as Freeman et al., 2017
In the citing paper
“Conversely, treating sleep disruption in students with insomnia lessens hallucinatory experiences, with over a third of the reduction in hallucinations attributable to improvements in insomnia. 3”
From Towards an Integrative Account of Potential Mechanisms Mediating the Path From Sleep Dysfunction to Hallucinations (2025) · cites this paper as [3]
In the citing paper
“Manipulation studies in non-clinical populations have since confirmed that sleep dysfunction is indeed a causal factor in the occurrence of hallucinatory experiences.”
From Towards an Integrative Account of Potential Mechanisms Mediating the Path From Sleep Dysfunction to Hallucinations (2025) · cites this paper as [3]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
“−1·85 (−2·66 to 1·04)”
§ The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis > Results
“−1·85 (−2·66 to 1·04) | <0·0001”
Citations
Cites
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A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765
Validation of the Insomnia Severity Index as an outcome measure for insomnia research
Bastien, C. (2001) · Sleep Medicine · doi:10.1016/s1389-9457(00)00065-4 · Cited by 8,067
The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation
Tennant, R., Hiller, L., Fishwick, R., Platt, S., Joseph, S., Weich, S., Parkinson, J., Secker, J., & Stewart-Brown, S. (2007) · Health and Quality of Life Outcomes · doi:10.1186/1477-7525-5-63 · Cited by 5,031
Kroenke, K., Spitzer, R. L., Williams, J. B. W., & Löwe, B. (2010) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2010.03.006 · Cited by 4,057
The Work and Social Adjustment Scale: a simple measure of impairment in functioning
Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. M. (2002) · British Journal of Psychiatry · doi:10.1192/bjp.180.5.461 · Cited by 2,515
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Self-citation
Metadata
- Authors
- 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., Gregory, A. M., Fleming, L., Walklet, E., Glazebrook, C., Davies, E. B., Hollis, C., Haddock, G., John, B., Coulson, M., Fowler, D., Pugh, K., Cape, J., Moseley, P., Brown, G., Hughes, C., Obonsawin, M., Coker, S., Watkins, E., Schwannauer, M., MacMahon, K., Siriwardena, A. N., & Espie, C. A.
- Affiliations
- National Health Service (GB)
- University of Oxford (GB)
- Manchester Academic Health Science Centre (GB)
- Warneford Hospital (GB)
- Gartnavel General Hospital (GB)
- University of Plymouth (GB)
- University of Bristol (GB)
- University of Sheffield (GB)
- University of Liverpool (GB)
- University of Leicester (GB)
- Swansea University (GB)
- Goldsmiths University of London (GB)
- University of Strathclyde (GB)
- University of Worcester (GB)
- University of Nottingham (GB)
- University of Manchester (GB)
- University of South Wales (GB)
- Middlesex University London (GB)
- University of Sussex (GB)
- Sussex Partnership NHS Foundation Trust (GB)
- University College London (GB)
- University of Lancashire (GB)
- Royal Holloway University of London (GB)
- University of Cambridge (GB)
- University of Exeter (GB)
- University of Edinburgh (GB)
- University of Lincoln (GB)
- Corresponding author
- Freeman, Daniel
- ORCID
- Freeman, Daniel
- Sheaves, Bryony
- Goodwin, Guy M
- Yu, Ly-Mee
- Nickless, Alecia
- Harrison, Paul J
- Emsley, Richard
- Luik, Annemarie I
- Gumley, Andrew
- Jones, Ray
- Lightman, Stafford
- Bentall, Richard
- Kinderman, Peter
- Rowse, Georgina
- Brugha, Traolach
- Blagrove, Mark
- Gregory, Alice M
- Fleming, Leanne
- Glazebrook, Cris
- Davies, E Bethan
- Hollis, Chris
- Haddock, Gillian
- John, Bev
- Coulson, Mark
- Fowler, David
- Cape, John
- Moseley, Peter
- Brown, Gary
- Hughes, Claire
- Obonsawin, Marc
- Watkins, Edward
- Schwannauer, Matthias
- MacMahon, Kenneth
- Siriwardena, A Niroshan
- Espie, Colin A
- Venue
- The Lancet Psychiatry
- Publisher
- Elsevier BV
- Published
- 2017-10
- Volume
- 4
- Issue
- 10
- Pages
- 749-758
- ISSN
- 2215-0366 (ISSN-L)
- PMC
- PMC5614772
- OpenAlex
- W2753665614
- Semantic Scholar
- 797208a87ff04f1f341f2798f7ab7f8db93086ba
- Cited by
- 652
- References
- 38
- Citations by year
- 2026: 53 · 2025: 68 · 2024: 73 · 2023: 80 · 2022: 83 · 2021: 98 · 2020: 83 · 2019: 55 · 2018: 46 · 2017: 11
- FWCI
- 69.44
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- The Lancet Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Open Research Exeter (University of Exeter) (publishedVersion, cc-by)
- CLOK (University of Central Lancashire) (acceptedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- Research Repository (University of Gloucestershire) (acceptedVersion)
- Goldsmiths (University of London) (acceptedVersion)
- Lincoln Repository (University of Lincoln) (acceptedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Northumbria Research Link (Northumbria University) (acceptedVersion)
- Strathprints: The University of Strathclyde institutional repository (University of Strathclyde) (acceptedVersion)
- UEA Digital Repository (University of East Anglia) (acceptedVersion)
- Leicester Research Archive (University of Leicester) (acceptedVersion, other-oa)
- Research Repository (University of Gloucestershire) (submittedVersion, other-oa)
- Explore Bristol Research (submittedVersion, cc-by)
- Sussex Research Online (University of Sussex) (submittedVersion, cc-by)
- Worcester Research and Publications (University of Worcester) (submittedVersion)
- Lancaster EPrints (Lancaster University) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Figshare (submittedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by)
- PEARL (University of Plymouth) (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion, cc-by)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
- Bristol Research (University of Bristol) (submittedVersion, cc-by)
- Funders
- Wellcome Trust (098461/Z/12/Z)
- National Institute for Health and Care Research (RP-2014-05-003, NF-SI-0514-10119)
- University of Oxford
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- insomnia, cognitive behavioral therapy for insomnia, paranoia, hallucinations, psychotic experiences, sleep disruption, university students, mental health, mediation analysis, digital psychological interventions
- MeSH terms
- Adolescent, Adult, Female, United Kingdom, Hallucinations, Humans, Sleep Initiation and Maintenance Disorders, Male, Mental Health, Paranoid Disorders, Sleep, Students, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-09, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-09 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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