Implications for research and practice
Patients that did have improved sleep efficiency also reported concerns, most commonly that 4 weeks of SRT was not long enough. All participants found the first week of the intervention very difficult as their body adjusted to limited time in bed. By the third week some were seeing significant benefits. For example, one participant who had improvements in sleep efficiency spoke of being woken by their alarm for the first time in years. Others only started to see benefits by the final week and as such felt the loss of support at the end of the intervention had a direct impact on their motivation to continue. Those that saw improvements earlier expressed being more likely to continue after treatment, whereas those that felt benefits later were more likely to revert to previous habits. One patient reported taking a nap in the afternoon the day after the final session and that they quickly reverted to their previous habits as there was no-one ‘watching over them’. This is a significant finding that indicated the importance of individual, personalised delivery with regular checks continuing for some until new habits and sleep patterns were reinforced. It may be relevant to think about cost-effective refinements to SRT based on these findings, such as extending SRT weekly sessions beyond 4 weeks.Previous research has shown that it was possible for a GP to deliver an adapted version of SRT in general practice,In conclusion, SRT can be successfully delivered by nurses in general practice and was generally well received by patients. Ongoing support after the initial intervention period should be assessed to determine whether this leads to improved adherence and outcome.The authors would like to acknowledge the participants who undertook the intervention, the nurses who delivered the intervention, and the practice managers and GPs who supported the research within their practices.