A Qualitative Study of Early Intervention Psychosis (EIP) Service Patient’s Experience of Sleep, Exercise, Sleep Hygiene Advice and Fitbit Wearable Activity and Sleep Tracker

Abstract

Background: In psychosis physical activity, sleep, mental health, physical health, wellbeing, quality of life, cognition and functioning are interconnected. People who experience psychosis are more likely than the general population to have low levels of physical activity, high levels of sedentary behaviour and sleep problems. This project was innovative in seeking to address these issues through provision of a wearable activity and sleep tracker (a Fitbit) and sleep hygiene advice. Participants: Participants using an early intervention psychosis (EIP) service took part in an eight-week intervention, which incorporated the provision of a Fitbit, sleep hygiene advice as well as three engagement, feedback and discussion points with a clinician. Methods: A qualitative approach was used to conduct in-depth semi-structured interviews with 12 of the 25 intervention participants (5 male; 7 female). Thematic and content analyses were employed to analyse the data. Results: Participants provided valuable insights into their experience of sleep, exercise, Fitbit use and sleep hygiene advice use. It was found that participants placed a high value on effective night time sleep, recognized improvements in physical activity and noted a positive effect on mood and wellbeing as a result of Fitbit use. The negative impact of having ineffective night time sleep and insufficient physical activity was described. Participants demonstrated a good level of understanding of the connection between sleep, exercise, wellbeing, and health. Conclusion: Participants reported the Fitbit and sleep hygiene advice received through an EIP service to be beneficial for improved levels of physical activity and exercise, and more effective sleep. This is a simple and low cost intervention which could be made widely available through EIP and other mental health services.

The over‐35s: prediabetes and diabetes within an EIP service

“…Prediabetes: All patients were given lifestyle modification advice, as well as offered other interventions such as walking groups and the offer to participate in our Welltrack study (use of Fitbit to improve activity and well-being). 31,32 Patients were also referred to a GP for further lifestyle modification, and one patient enrolled in the NHS Diabetes Prevention Programme. One patient participated in the Well-track study.…”

“…In total five of six patients with diabetes had either already participated in the Well-track (Fitbit) 31,32 study or had started to participate.…”

Sleep Disturbances in At-Risk Mental States and First Episode of Psychosis: A Narrative Review on Interventions

“…Basic sleep hygiene education, such as avoiding caffeine or alcohol consumption, having a specific bedroom, maintaining sleep regularity, avoiding daytime naps and stress management, has been shown to be beneficial in people with psychosis [ 4 , 45 ], particularly if coupled with a portable sleep tracker [ 46 ]. This consists of a wearable tracker (Fitbit) that can detect sleep and physical activity.…”

The nature, consequences, mechanisms, and management of sleep disturbances in individuals at-risk for psychosis

“…Basic sleep hygiene education has proven to be beneficial in people with psychosis ( 11 , 46 ). In this regard, some authors demonstrated the benefits of a low cost and simple sleep intervention for early psychosis patients, consisting of sleep hygiene advice along with a provision of a wearable sleep tracker ( 86 ). Accumulated evidence has confirmed the effectiveness of the Cognitive Behavioral Therapy for insomnia (CBTi) in UHR states ( 80 , 82 , 87 ).…”