2 - (IOP 2) The Use of Wearable Technology and Individualized Imagery Scripts on Outcomes of Sleep, Psychosis, and Suicidality Among Inpatients

Intro: Individuals with psychosis often have high rates of inpatient hospitalization, increased risk of suicidality, and sleep disruption. Sleep disruption often exacerbates psychotic symptoms and is associated with increased suicidality, yet sleep is an often-overlooked intervention target in this population. Imagery Rehearsal Therapy (IRT), a form of Cognitive Behavioral Therapy (CBT), has large effects on sleep quality and symptomatology, yet no interventions have been investigated with inpatients with psychosis. The current study utilizes wearable technology to administer and monitor the effectiveness of a sleep intervention on sleep disruption, psychotic symptoms, and suicidal ideation among inpatients with psychosis.

Method: Participants were enrolled in the Recovery-oriented Treatment Program (ROTP), an up-to 90-day multidisciplinary treatment program for subacute inpatients experiencing psychosis. In this randomized control trial, participants had primary diagnoses of a schizophrenia spectrum disorder or mood disorder with psychotic features. Participants allocated to the intervention condition created individualized imagery rehearsal scripts describing scenarios and/or places associated with relaxation. Audio recordings of the scripts were created by research personnel and uploaded to secure cell phones that participants used when attempting to sleep at night; audio recordings played on participants’ wireless earphones. They also wore a dry EEG headset (Muse S) that contains biosensors, including heart, breath, and movement (i.e., gyroscope) measures. Sleep data from EEG and other biometrics were collected, including a sleep score. Participants in the control condition wore the same technology without the individualized imagery scripts. Participants also completed self-report and interview-based measures of psychosis, sleep, mood, and suicidal ideation at baseline, bi-weekly, and at discharge. Participants’ satisfaction with the intervention and technology was also examined at discharge.

Results: Ten patients are currently enrolled. Preliminary results indicate the intervention, compared to control condition, was associated with increased relaxation during sleep and greater sleep quality in objective measurements, though no effect was found for subjective sleep, mood, suicidality, or psychosis.

Discussion: Preliminary results suggest the feasibility of wearable technology for providing personalized, CBT-based imagery audio and for measuring objective sleep among inpatients with psychosis.