Evidence map›Paper›PMID 38154945›Full record

Trial reportThe British journal of general practice : the journal of the Royal College of General Practitioners2024

Nurse-delivered sleep restriction therapy in primary care for adults with insomnia disorder: a mixed-methods process evaluation.

Stephanie Armstrong, Julie Pattinson, Aloysius Niroshan Siriwardena, Simon D Kyle, Peter Bower, Ly-Mee Yu, Yaling Yang, Emma Ogburn, Nargis Begum, Leonie Maurer and 6 more

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The British journal of general practice : the journal of the Royal College of General Practitioners, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
1.5field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 4 institutions in 1 country.

Stephanie ArmstrongCommunity and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK.ORCID 0000-0002-2599-4844
Julie PattinsonCommunity and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK.ORCID 0000-0002-9824-3400
Aloysius Niroshan SiriwardenaCommunity and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK.ORCID 0000-0003-2484-8201
Simon D KyleSleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.ORCID 0000-0002-9581-5311
Peter BowerNational Institute for Health and Care Research School for Primary Care Research, Centre for Primary Care and Health Services Research, University of Manchester, Manchester, UK.ORCID 0000-0001-9558-3349
Ly-Mee YuNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0003-0331-7364
Yaling YangNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0002-9529-1685
Emma OgburnNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0001-7643-572X
Nargis BegumNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0002-8628-0319
Leonie MaurerMementor DE GmbH, Leipzig, Germany.ORCID 0000-0001-7335-2320
Barbara RobinsonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0002-1721-7682
Caroline GardnerCentre for Primary Care and Health Services Research, University of Manchester, Manchester, UK.ORCID 0000-0003-0487-3979
Victoria LeeCentre for Primary Care and Health Services Research, University of Manchester, Manchester, UK.ORCID 0000-0001-9578-3260
Dimitri GavriloffSleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.ORCID 0000-0001-9793-0885
Colin A EspieSleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.ORCID 0000-0002-1294-8734
Paul AveyardNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0002-1802-4217
University of Oxford · GBManchester Academic Health Science Centre · GBUniversity of Lincoln · GBUniversity of Manchester · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSleep restriction therapy (SRT) is a behavioural therapy for insomnia.

aimTo conduct a process evaluation of a randomised controlled trial comparing SRT delivered by primary care nurses plus a sleep hygiene booklet with the sleep hygiene booklet only for adults with insomnia disorder. DESIGN AND

settingA mixed-methods process evaluation in a general practice setting.

methodSemi-structured interviews were conducted in a purposive sample of patients receiving SRT, the practice nurses who delivered the therapy, and also GPs or practice managers at the participating practices. Qualitative data were explored using framework analysis, and integrated with nurse comments and quantitative data, including baseline Insomnia Severity Index score and serial sleep efficiency outcomes to investigate the relationships between these.

resultsIn total, 16 patients, 13 nurses, six practice managers, and one GP were interviewed. Patients had no previous experience of behavioural therapy, needed flexible appointment times, and preferred face-to-face consultations; nurses felt prepared to deliver SRT, accommodating patient concerns, tailoring therapy, and negotiating sleep timings despite treatment complexity and delays between training and intervention delivery. How the intervention produced change was explored, including patient and nurse interactions and patient responses to SRT. Difficulties maintaining SRT, negative attitudes towards treatment, and low self-efficacy were highlighted. Contextual factors, including freeing GP time, time constraints, and conflicting priorities for nurses, with suggestions for alternative delivery options, were raised. Participants who found SRT a positive process showed improvements in sleep efficiency, whereas those who struggled did not.

conclusionSRT was successfully delivered by practice nurses and was generally well received by patients, despite some difficulties delivering and applying the intervention in practice.

Indexed as

Sleep Initiation and Maintenance DisordersAdultFamily PracticeHumansPrimary Health CareSleepSleep HygieneTreatment Outcomecognitive behavior therapygeneral practiceinsomnia disordernursing primary careprogramme evaluation

Identifiers

PMID38154945
PMCPMC10756002
OpenAlexW4386775954

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.