# Sleep Complaints in the Psychiatric Hospital: A Qualitative Study of Nurses and Psychiatrists’ Approaches to Sleep Management in a Swiss Psychiatric Hospital

## TL;DR

This study explores how psychiatrists and nurses in a Swiss psychiatric hospital handle sleep complaints among inpatients, revealing a lack of standardized, evidence-based approaches.

## Contribution

The study provides new insights into the qualitative perspectives and practices of healthcare professionals in managing insomnia in psychiatric inpatients.

## Key findings

- Healthcare professionals use a heterogeneous and non-evidence-based approach to manage insomnia symptoms.
- There is a lack of hospital-specific guidelines and adaptation of CBT-I for psychiatric inpatients.
- Current guidelines focus on chronic insomnia and overlook the complexity of psychiatric cases.

## Abstract

Insomnia symptoms are very common among psychiatric inpatients and can increase the risk of suicide in this population. However, little is known about how psychiatrists and nurses manage insomnia symptoms in psychiatric inpatients. This study aimed to investigate the views, opinions, and experiences of psychiatrists and nurses regarding inpatients’ sleep complaints in a Swiss psychiatric hospital. This qualitative study used individual semi-structured interviews with a purposive sample of psychiatrists and nurses working in a Swiss psychiatric hospital. Interviews were audio-recorded, transcribed verbatim, and analysed manually using inductive thematic analysis. Ten participants (six psychiatrists and four nurses) were interviewed. Three overarching themes were identified: identifying and classifying sleep complaints, the decision-making process, and the actions taken to respond to the complaint. Insomnia symptoms were approached by psychiatrists and nurses in a highly heterogeneous, non-evidence-based manner, with a lack of adaptation of CBT-I leading to overmedication. This heterogeneity may be explained by the diversity of underlying problems associated with insomnia symptoms, the lack of hospital-specific guidelines, and the fact that current guidelines focus mainly on chronic insomnia and do not fully account for the complexity of psychiatric inpatients.