The patient experience of sleep problems and their treatment in the context of current delusions and hallucinations
Open accessAbstract
OBJECTIVES: There is increasing recognition that sleep problems are common in patients with psychosis, that they exacerbate delusions and hallucinations and should be a treatment target. The aim of this study was to gain a patient perspective on the nature of sleep problems in psychosis and experience of treatment. DESIGN: A qualitative, semi-structured interview-based study to explore patient accounts of sleep problems and associated psychological treatment. METHODS: Ten patients with recent delusions and hallucinations, who had experienced sleep problems and received psychological treatment during a clinical trial (the Better Sleep Trial), were interviewed. Responses were analysed using interpretative phenomenological analysis. RESULTS: Patients reported experiencing problems of getting to sleep, staying asleep, too much sleep, nightmares, and erratic sleep patterns. These sleep problems caused emotional distress, fatigue, and reduction in daytime activities. Worry and psychotic experiences disturbed sleep, while consequent tiredness meant that patients coped poorly with voices and persecutory fears. Treatment for sleep problems was viewed very positively and considered to have wide-ranging impacts. CONCLUSIONS: Sleep disturbance is a major problem for patients with psychosis, which should be treated more often in services using evidence-based interventions. PRACTITIONER POINTS: Psychological interventions for sleep problems are valued by patients with psychosis. Patients with current distressing psychotic experiences report wide-ranging benefits from a brief psychological intervention for sleep problems.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
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?
Feeling worn down due to sleep dysfunction alters the response to voices.
“Feeling worn down due to sleep dysfunction alters the response to voices”
From Towards an Integrative Account of Potential Mechanisms Mediating the Path From Sleep Dysfunction to Hallucinations (2025) · cites this paper as [7]
Improved sleep following psychological sleep treatment can lead to positive changes in the voice-hearing experience.
“Improved sleep following psychological sleep treatment can lead to positive changes in the voice-hearing experience”
From Towards an Integrative Account of Potential Mechanisms Mediating the Path From Sleep Dysfunction to Hallucinations (2025) · cites this paper as [7]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Interpretative Phenomenological Analysis: Theory, Method and Research
(2010) · QMiP Bulletin · doi:10.53841/bpsqmip.2010.1.10.44 · Cited by 8,189 · see citing works
Baglioni, C., Battagliese, G., Feige, B., Spiegelhalder, K., Nissen, C., Voderholzer, U., Lombardo, C., & Riemann, D. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.01.011 · Cited by 2,779 · see citing works
Smith, J. A. (1996) · Psychology & Health · doi:10.1080/08870449608400256 · Cited by 2,380 · see citing works
Dilemmas in qualitative health research
Yardley, L. (2000) · Psychology & Health · doi:10.1080/08870440008400302 · Cited by 2,310 · see citing works
Ruhrmann, S., Schultze-Lutter, F., Salokangas, R. K. R., Heinimaa, M., Linszen, D., Dingemans, P., Birchwood, M., Patterson, P., Juckel, G., Heinz, A., et al. (2010) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2009.206 · Cited by 632 · see citing works
Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic review
Mitchell, M. D., Gehrman, P., Perlis, M., & Umscheid, C. A. (2012) · BMC Family Practice · doi:10.1186/1471-2296-13-40 · Cited by 617 · see citing works
Sivertsen, B., Omvik, S., Pallesen, S., Bjorvatn, B., Havik, O. E., Kvale, G., Nielsen, G. H., & Nordhus, I. H. (2006) · JAMA · doi:10.1001/jama.295.24.2851 · Cited by 589 · cited 1× · see citing works
“However, there is a substantial literature showing the benefits of such interventions for insomnia (Sivertsen et al., 2006).”
BackgroundInsomnia and health-related quality of life
Kyle, S. D., Morgan, K., & Espie, C. A. (2010) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2009.07.004 · Cited by 520 · see citing works
Sleep and circadian rhythm disruption in schizophrenia
Wulff, K., Dijk, D.-J., Middleton, B., Foster, R. G., & Joyce, E. M. (2012) · British Journal of Psychiatry · doi:10.1192/bjp.bp.111.096321 · Cited by 426 · see citing works
Freeman, D., Stahl, D., McManus, S., Meltzer, H., Brugha, T., Wiles, N., & Bebbington, P. (2012) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-011-0433-1 · Cited by 246 · see citing works
Insomnia, Psychiatric Disorders, and the Transdiagnostic Perspective
Harvey, A. G. (2008) · Current Directions in Psychological Science · doi:10.1111/j.1467-8721.2008.00594.x · Cited by 232 · see citing works
Self-citationAn open trial of cognitive therapy for chronic insomnia
Harvey, A. G., Sharpley, A. L., Ree, M. J., Stinson, K., & Clark, D. M. (2007) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.04.007 · Cited by 219 · see citing works
Self-citationFreeman, D., Waite, F., Startup, H., Myers, E., Lister, R., McInerney, J., Harvey, A. G., Geddes, J., Zaiwalla, Z., Luengo-Fernandez, R., et al. (2015) · The Lancet Psychiatry · doi:10.1016/s2215-0366(15)00314-4 · Cited by 219 · see citing works
Kyle, S. D., Morgan, K., Spiegelhalder, K., & Espie, C. A. (2011) · Sleep Medicine · doi:10.1016/j.sleep.2011.03.016 · Cited by 199 · see citing works
Sleep disturbance in mental health problems and neurodegenerative disease
Anderson, K. N., & Bradley (2013) · Nature and Science of Sleep · doi:10.2147/nss.s34842 · Cited by 185 · see citing works
Sleep disturbance in schizophrenia
Monti, J., & Monti, D. (2005) · International Review of Psychiatry · doi:10.1080/09540260500104516 · Cited by 175 · see citing works
Myers, E., Startup, H., & Freeman, D. (2011) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2011.02.004 · Cited by 170 · see citing works
Self-citationFreeman, D., Pugh, K., Vorontsova, N., & Southgate, L. (2009) · Schizophrenia Research · doi:10.1016/j.schres.2008.12.001 · Cited by 158 · see citing works
Self-citationQuality of sleep in patients with schizophrenia is associated with quality of life and coping
Hofstetter, J. R., Lysaker, P. H., & Mayeda, A. R. (2005) · BMC Psychiatry · doi:10.1186/1471-244x-5-13 · Cited by 155 · see citing works
Treating Sleep Problems in Patients with Schizophrenia
Waite, F., Myers, E., Harvey, A. G., Espie, C. A., Startup, H., Sheaves, B., & Freeman, D. H. (2015) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465815000430 · Cited by 103 · see citing works
Self-citationFocusing on the Experience of Insomnia
Carey, T. J., Moul, D. E., Pilkonis, P. A., Germain, A., & Buysse, D. J. (2005) · Behavioral Sleep Medicine · doi:10.1207/s15402010bsm0302_2 · Cited by 102 · see citing works
Freeman, D., Brugha, T., Meltzer, H., Jenkins, R., Stahl, D., & Bebbington, P. (2010) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2010.03.018 · Cited by 99 · see citing works
Self-citationThe development and impact of insomnia on cancer survivors: a qualitative analysis
Fleming, L., Gillespie, S., & Espie, C. A. (2009) · Psycho-Oncology · doi:10.1002/pon.1652 · Cited by 83 · see citing works
Positive and Negative Syndromes in Schizophrenia
Buchanan, R. W. (1993) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199302000-00021 · Cited by 78 · see citing works
Kilbride, M., Byrne, R. E., Price, J., Wood, L., Barratt, S., Welford, M., & Morrison, A. P. (2012) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465812000495 · Cited by 48 · see citing works
The Insomnia Patient Perspective, A Narrative Review
Cheung, J. M. Y., Bartlett, D. J., Armour, C. L., & Saini, B. (2013) · Behavioral Sleep Medicine · doi:10.1080/15402002.2012.694382 · Cited by 35 · see citing works
A study on the experience of insomnia in a psychiatric inpatient population
Collier, E. H., Skitt, G., & Cutts, H. (2003) · Journal of Psychiatric and Mental Health Nursing · doi:10.1046/j.1365-2850.2003.00654.x · Cited by 28 · see citing works
Freeman, D. H., Startup, H. M., Myers, E., Harvey, A. G., Geddes, J. R., Yu, L., Zaiwalla, Z., Luengo-Fernández, R., Foster, F., & Lister, R. (2013) · Trials · doi:10.1186/1745-6215-14-214 · Cited by 25 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 3
- Freeman, D., Waite, F., Startup, H., Myers, E., Lister, R., McInerney, J., … Yu, L.‐M. (in press). A randomi sed controlled pilot trial testing the effects of cognitive behavioural therapy to improve sleep for patients with persistent delusions and hallucinations: The Better Sleep Trial (BEST). The Lancet Psychiatry. PMC4641164 26363701
- Meir, H., & Kryger, M. (2004). A woman's guide to sleep disorders. New York, NY: McGraw‐Hill.
- Yardley, L. (2008). Demonstrating validity in qualitative health research In Smith J. A. (Ed.), Qualitative psychology: A practical guide to methods (2nd ed., pp. 235– 251). London, UK: Sage.
Cited by
Sorted by citations
Scott, A. J., Webb, T. L., Martyn-St James, M., Rowse, G., & Weich, S. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2021.101556 · Cited by 1,094 · see citing works
Sleep disturbance and psychiatric disorders
Freeman, D., Sheaves, B., Waite, F., Harvey, A. G., & Harrison, P. J. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30136-x · Cited by 843 · see citing works
Self-citationPersecutory delusions: a cognitive perspective on understanding and treatment.
Freeman, D. (2016) · The Lancet Psychiatry · doi:10.1016/s2215-0366(16)00066-3 · Cited by 356 · see citing works
The role of sleep dysfunction in the occurrence of delusions and hallucinations: A systematic review
Reeve, S., Sheaves, B., & Freeman, D. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.09.001 · Cited by 273 · see citing works
Self-citationFreeman, D., Waite, F., Startup, H., Myers, E., Lister, R., McInerney, J., Harvey, A. G., Geddes, J., Zaiwalla, Z., Luengo-Fernandez, R., et al. (2015) · The Lancet Psychiatry · doi:10.1016/s2215-0366(15)00314-4 · Cited by 219 · see citing works
Sleep disorders in early psychosis: incidence, severity, and association with clinical symptoms
Reeve, S., Sheaves, B., & Freeman, D. (2019) · Schizophrenia Bulletin · doi:10.1093/schbul/sby129 · Cited by 182 · see citing works
Reeve, S., Emsley, R., Sheaves, B., & Freeman, D. (2017) · Schizophrenia Bulletin · doi:10.1093/schbul/sbx103 · Cited by 131 · see citing works
Self-citationReeve, S., Nickless, A., Sheaves, B., & Freeman, D. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.08.090 · Cited by 69 · see citing works
Self-citationSheaves, B., Cropley, V. L., Moseley, P., Woodruff, P. W. R., Punton, G., Speth, C., Speth, J., Meerlo, P., & Brederoo, S. G. (2025) · Schizophrenia Bulletin · doi:10.1093/schbul/sbaf107 · Cited by 6 · see citing works
- Authors
- Waite, F., Evans, N., Myers, E., Startup, H., Lister, R., Harvey, A. G., & Freeman, D.
- Affiliations
- Warneford Hospital (GB)
- East London NHS Foundation Trust (GB)
- Sussex Partnership NHS Foundation Trust (GB)
- University of California, Berkeley (US)
- Corresponding author
- Waite, Felicity
- Venue
- Psychology and Psychotherapy Theory Research and Practice
- Publisher
- Wiley
- Published
- 2015-08-18
- Volume
- 89
- Issue
- 2
- Pages
- 181-193
- ISSN
- 1476-0835 (ISSN-L)
- 2044-8341
- PMC
- PMC4879509
- OpenAlex
- W2106062833
- Cited by
- 85
- References
- 28
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 5 · 2023: 11 · 2022: 5 · 2021: 14 · 2020: 8 · 2019: 5 · 2018: 7 · 2017: 7 · 2016: 5 · 2015: 3
- FWCI
- 11.08
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Psychology and Psychotherapy Theory Research and Practice (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Funders
- NHS NIHR Research for Patient Benefit Programme (PB-PG-0211-10007)
- Medical Research Council Senior Clinical Fellowship (G0902308)
- Wellcome Trust Strategic Award (098461/Z/12/Z)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- sleep disorders, psychosis, delusions, hallucinations, patient experience, psychological intervention, nightmares, fatigue, voice, treatment acceptability
- MeSH terms
- Adaptation, Psychological, Adult, Aged, Delusions, Female, Hallucinations, Humans, Interviews as Topic, Male, Middle Aged, Psychiatric Status Rating Scales, Psychotherapy, Psychotic Disorders, Sleep Wake Disorders, 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.
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 ›
Are you an author, or do you see a problem with this page? Request a review
