Trouble sleeping inside: a cross-sectional study of the prevalence and associated risk factors of insomnia in adult prison populations in England.
Trouble sleeping inside: a cross-sectional study of the prevalence and associated risk factors of insomnia in adult prison populations in England.
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DOI：
10.1016/j.sleep.2016.12.018
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发表时间：
2017-04
期刊：
影响因子：
4.8
通讯作者：
Senior J
中科院分区：
文献类型：
--
作者：
Dewa LH;Hassan L;Shaw JJ;Senior J
调查英国成年囚犯中失眠的患病率，并确定相关的人口统计学、临床和法医风险因素。对英格兰北部两所男性监狱和一所女性监狱的237名18-72岁的囚犯进行了横断面研究。我们使用睡眠状况指标来衡量可能的DSM-V失眠障碍（ID）和匹兹堡睡眠质量指数来检查睡眠质量。多种人口统计、睡眠、临床和法医自我报告的措施被记录下来，以确定与失眠的任何关联。总体而言，可能的DSM-V ID患病率为61.6% （95% CI, 55.5%-67.8%）。主观睡眠质量差的占88.2% （95% CI, 84.1% ~ 92.3%）。十分之七（70.6%）的女性囚犯可能患有DSM-V型ID （95% CI, 64.8%-76.4%）。对性别和年龄进行调整后的多变量logistic回归分析显示，在监狱中可能存在身份证的几率因以下因素而增加：身体不健康史（OR = 3.62, 95% CI, 1.31-9.98）；自杀倾向（OR = 2.79, 95% CI, 1.01.7.66）、曾因失眠（OR = 2.58, 95% CI, 1.21-5.47）、抑郁（OR = 2.06, 95% CI, 1.31-3.24）、对睡眠的不正常信念（OR = 1.50, 95% CI, 1.21-1.87）、较差的睡眠卫生（OR = 1.11, 95% CI, 1.04-1.19）和有问题的监狱环境（例如，噪音、光线或温度）（OR = 1.07, 95% CI, 1.02-1.12）寻求过帮助。我们第一次在英国成年囚犯的大样本中确定了失眠的患病率和相关因素。失眠和睡眠质量差是很常见的，尤其是在女性囚犯中。这些发现强调/放大了需要专门的治疗途径，以改善监狱中失眠症的筛查、评估和治疗。可能的失眠症在囚犯中非常普遍，在女性囚犯中更常见。失眠与监狱环境问题、抑郁、自杀和身体健康不佳有关。失眠与糟糕的睡眠卫生和不适应睡眠的信念有关。没有发现失眠和药物滥用之间的联系。高患病率证明了未来针对囚犯失眠治疗研究的重要性。
To investigate the prevalence of insomnia and identify associated demographic, clinical and forensic risk factors in adult prisoners in England. A cross-sectional study of 237 prisoners aged 18–72 years, across two male prisons and one female prison in North England. We used the Sleep Condition Indicator to measure probable DSM-V insomnia disorder (ID) and the Pittsburgh Sleep Quality Index to examine sleep quality. Multiple demographic, sleep, clinical and forensic self-reported measures were recorded to identify any associations with insomnia. Overall, the prevalence of possible DSM-V ID was 61.6% (95% CI, 55.5%–67.8%). Subjective poor sleep quality was reported by 88.2% (95% CI, 84.1%–92.3%). Seven in ten (70.6%) female prisoners had possible DSM-V ID (95% CI, 64.8%–76.4%). Multivariable logistic regression analysis, adjusting for gender and age, indicated odds of having possible ID in prison were increased for the following factors: history of physical ill-health (OR = 3.62, 95% CI, 1.31–9.98); suicidality (OR = 2.79, 95% CI, 1.01.7.66), previously asked for help for insomnia (OR = 2.58, 95% CI, 1.21–5.47), depression (OR = 2.06, 95% CI 1.31–3.24), greater endorsement of dysfunctional beliefs about sleep (OR = 1.50, 95% CI, 1.21–1.87), poor sleep hygiene (OR = 1.11, 95% CI, 1.04–1.19), and problematic prison environment (eg, noise, light or temperature) (OR = 1.07, 95% CI, 1.02–1.12). For the first time we have established the prevalence and associated factors of insomnia in a large sample of adult English prisoners. ID and poor sleep quality are common, especially in female prisoners. These findings emphasize/amplify the need for dedicated treatment pathways to improve screening, assessment and treatment of insomnia in prison. Possible insomnia disorder was highly prevalent in prisoners and more likely in women prisoners. Insomnia was associated with a problematic prison environment, depression, suicidality and physical-ill health. Insomnia was associated with poor sleep hygiene and maladaptive beliefs about sleep. No association was found between insomnia and substance misuse. The high prevalence endorses the importance of future research on treatment targeting insomnia in prisoners.