Comparison with existing literature
tiredness
ADVERSE EFFECTS
Patients and nurses reported that they were able to quickly grasp the purpose of SRT and related processes. Patients preferred face-to-face consultations and felt that these helped maintain motivation. Although face-to-face interactions have been found to be preferred in some studies, overall the evidence is lacking that therapeutic alliance, disclosure, empathy, attentiveness, or participation differs in face-to-face compared with telephone delivery of psychological interventions.All patients interviewed found the first week of therapy difficult because of reduced time in bed and strict bed and rising times. This is consistent with previous evaluations of SRT, where participants reported worsening of daytime functioning in the first week with improvements felt after a period of adjustment.In this study there was negotiation between the nurses and the patients regarding sleep times and the need for flexibility, which was supported to some extent by the protocol.Participants reported adverse effects such as increased tiredness, ‘exhaustion’, and worries about driving, which have been found in other studies.