Outcomes of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) in a community setting: Unpacking comorbidity

• Published in: Behaviour research and therapy 2021-10, Vol.145, p.103948-103948, Article 103948
• Main Authors: Sarfan, Laurel D., Hilmoe, Heather E., Gumport, Nicole B., Gasperetti, Caitlin E., Zieve, Garret G., Harvey, Allison G.
• Format: Article
• Language: English
• Subjects: Circadian; Circadian Rhythm; Circadian rhythms; Community mental health; Comorbid; Comorbidity; Delayed; Humans; Hypersomnia; Insomnia; Intervention; Medical diagnosis; Mental disorders; Psychiatric symptoms; Psychosocial factors; Restless legs syndrome; Rhythm; Serious mental illness; Sleep; Sleep disorders; Sleep Initiation and Maintenance Disorders; Symptoms; Transdiagnostic
• ISSN: 0005-7967; 1873-622X; 1873-622X
• DOI: 10.1016/j.brat.2021.103948

Comorbidity and subdiagnostic symptoms are understudied for sleep and circadian problems. We evaluated 1) impairment associated with (a) number of sleep and circadian problems and (b) diagnostic threshold (full diagnosis vs. subdiagnostic symptoms), and 2) Transdiagnostic Sleep and Circadian Intervention (TranS-C) outcomes for participants with specific sleep and circadian problems. Community participants (N = 121) with serious mental illness and sleep and circadian problem(s) were randomized to receive TranS-C plus usual care (TranS-C + UC) or usual care plus delayed TranS-C (UC-DT). Overall impairment, psychiatric symptoms, and sleep and circadian dysfunction were assessed at pre-treatment, post-treatment, and 6-month follow-up. Higher numbers of sleep and circadian problems, versus one problem, were associated with worse overall impairment, psychiatric symptoms, and sleep and circadian dysfunction (ps  0.05). TranS-C + UC versus UC-DT was associated with psychosocial and sleep and circadian improvements for specific sleep and circadian problems (insomnia, hypersomnia, parasomnias, periodic limb movement/restless leg syndrome, circadian rhythm disorders), though improvements varied by problem. TranS-C + UC outcomes were not moderated by number of sleep and circadian problems (ps > 0.05). Higher numbers of sleep and circadian problems, not diagnostic threshold, were associated with greater impairment. Transdiagnostic utility of TranS-C + UC was supported. •Higher numbers of sleep/circadian problems were associated with poorer functioning.•Diagnostic threshold of sleep/circadian problems was not associated with functioning.•TranS-C improved functioning across individuals with specific sleep/circadian problems.•TranS-C effects were not moderated by number of sleep/circadian problems.•Transdiagnostic utility of TranS-C was supported.