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Sleeping Better: A Randomised Controlled Trial Testing the Effects of Treating Sleep Difficulties in Patients at Ultra-High Risk of Psychosis and Patients Diagnosed with Non-Affective Psychosis 

Most people with psychosis report sleep problems that are troubling for them, that exacerbate affective and psychotic symptoms, and that make thinking and everyday functioning more difficult. We want to follow through on the implications of what patients are telling us: that sleep problems are a problem in their own right and that successful treatment will bring numerous additional benefits. We aim therefore to conduct the first definitive test of the idea that psychological therapy can help people with psychosis to enjoy greatly improved sleep and that this will lead to gains in many other aspects of people’s lives. 

Our team has pioneered the treatment of sleep problems in psychosis, conducting feasibility trials with patients at ultra-high risk of psychosis, with patients diagnosed with psychosis, and with people admitted to psychiatric hospital. In each trial our eight-session intervention has achieved large effect size improvements in sleep. 

We will conduct a randomised controlled trial with two cohorts: 554 patients at ultra-high risk of psychosis and 554 patients with diagnosed psychosis (e.g. schizophrenia). Each cohort (ultra-high risk, diagnosed psychosis) will be reported separately. The primary outcome is improvement in sleep but the trial is powered in each cohort to detect change in three important secondary outcomes (mood, psychotic experiences, and cognitive functioning). We will test in each cohort how and for whom the treatment works, and gain further insights from patients in a peer-led qualitative investigation.


Chief investigators: Daniel Freeman & Felicity Waite. Co-investigators: Kathryn Greenwood, Ly-Mee Yu, Thomas Kabir, Louise Johns, Helen Beckwith, Ava Forkert, Matthew Broome, Kate Chapman, Robert Dudley, Andrew Gumley, Gary Willington, Colin Espie, Russell Foster.  


Wellcome Trust