Light-Dark and Activity Rhythm Therapy for sleep: Feasibility and acceptability in Schizophrenia spectrum disorders (L-DART FitSz)

The L-DART FitSz study is designed and run by Sophie Faulkner (occupational therapist / clinical doctoral research fellow) and is sponsored by The Univerisity of Manchester and hosted by Greater Manchester Mental Health NHS Foundation Trust (GMMH). We will be recruiting participants for the main intervention study from April 2021 (and survey participants from slightly before this).

What is L-DART?

Light-Dark and Activity Rhythm Therapy (L-DART) is a new therapy we have developed to improve sleep in people with schizophrenia spectrum disorders.  It involves working on the rhythms of light and dark exposure (because we know that affects the body clock), and the type and timing of daily activities (because we know daytime activity affects sleep).  Because it involves changes to lifestyle and routines obviously there is homework!

It is delivered by an occupational therapist, and takes 7-9 sessions and 3-6 phone calls, spaced over 12 weeks.  It is quite personalised, and the goals we set will depend on the person’s interests, priorities and situation.

L-DART also involves the person tracking their own progress using an activity tracker watch (it doesn’t track where you are just how active you are), and a phone app: the L-DART app.  L-DART also uses light sensors, to see when you are exposed to light.

The aim of this study:

The aim is to see whether what we have developed is practical to deliver, and acceptable to the people receiving it. We are therefore recruiting 10 participants who will all be offered the intervention, and we will ask about acceptability and people’s views of receiving L-DART during and after using measures and a qualitative interview (with another researcher not Sophie).

Who are we looking for?

The main criteria for the intervention study are:

  • People with a diagnosis of schizophrenia, schizoaffective disorder, delusional disorder, or schizotypal disorder.
  • Who have problems with their sleep, such as: difficulty falling asleep, not getting enough sleep, poor sleep quality, broken sleep, unfreshing sleep, sleep timing which they are not happy with (e.g. erratically timed, too early or too late sleep).
  • In contact with GMMH or Pennine Care

ALSO staff participants: We are interested in the views of staff, and are surveying staff who work with clients from GMMH or Pennine Care, the anonymous online survey takes 5 minutes https://is.gd/LDARTstaff

ALSO anonymous service user survey participants: We are interested in all service user’s views about their sleep and receiving this kind of treatment, even if they don’t meet the criteria for, or want referring to, receive the intervention https://redcap.link/L-DARTsurvey

Full inclusion and exclusion criteria for the intervention study:

Inclusion criteria:
– Diagnosis of schizophrenia     schizotypal disorder       delusional disorder     OR schizoaffective disorder
– Under care of GMMH   OR Pennine Care
– Over 18
– Expresses dissatisfaction with sleep (time to fall asleep, amount of sleep, sleep quality,
broken sleep, unfreshing sleep, unsatisfactory sleep timing)
– Interested in receiving the intervention  		 Exclusion criteria:
– Change of medication within the last 1 month.
– Discharged from hospital within the last 1 month.
– Current inpatient or acuity of illness requiring home treatment team.
– Actively suicidal (expressing suicidal plans or intent). – Risk to others prevents lone visiting.

– Known untreated significant sleep apnoea (AHI Index >20, or symptomatic)
– Primary complaint is of sleep apnoea, sleep related movement disorder or parasomnia. – Diagnosis of narcolepsy or REM sleep behaviour disorder.

– Co-morbid learning disability, dementia, or moderate to severe neurological impairment.
– Alcohol or substance dependent (unsuitable if using heavily every day and/or not able to be sober for sessions).
– No fixed abode.
– Does not have capacity to give informed consent.

If you get in touch we will check all of the study criteria.

What is involved for people who take part?
All participants will receive the therapy (L-DART). There are study measures (questionnaires) at the beginning, middle and end (week 0, week 15, and week 30). There is an interview about the experience of receiving L-DART, with another researcher (Rory Byrne), which will be audio recorded and transcribed.
We will ask participants to wear an activity tracker watch, participants get to keep (choice of colours). For shorter periods we will also ask participants to wear an ‘actigraphy’ watch and light sensor.

Which organisations are running and funding the study?

The study is sponsored by University of Manchester, the host Trust is Greater Manchester Mental Health NHS Foundation Trust, and the project is funded by National Institute for Health Research (NIHR) (www.nihr.ac.uk).

Study video:

 

Documents to download:

Contact Sophie Faulkner:
Phone: 07990 344 544
Email:[email protected]

Version 1.2, updated on 15.01.2021