Sleep in Psychiatric Care (SIP): Treatment for Comorbid Delayed Sleep-Wake Phase Disorder (DSWPD)

The recommended treatment for Delayed Sleep-Wake phase disorder is bright light therapy (LT) at gradually advanced timing and/or melatonin administered in order to phase-advance the circadian rhythm. Recent research has proven that dark therapy, or blocking light in wavelengths \<530 nm by the use of for example orange blue-blocking glasses (bb-glasses), has shown the ability to maintain melatonin production comparable to darkness and to have an advancing effect on the circadian rhythm. The investigators therefore also want to test bb-glasses as an additive treatment to LT at gradually advanced timing.

The sleep-school at Bjørgvin District Psychiatric Hospital (DPS) is an already established treatment since 2017. The DSWPD-group gets together every other Monday from 1 pm until 3 pm. The group is open, which means that participants start at different dates and meet people in the group that might be at the end of their treatment, this often leads the group to function as a support for each other. Participants are patients at the general psychiatric outpatient clinic at Bjørgvin DPS in Bergen, Norway. Participants have been referred to the sleep-team by their psychologist or doctor. In this RCT the investigators will carry on the same structure for the group for participants that are recruited to the RCT, hence the project has high ecological validity.

All participants have an individual consultation before joining the group where the focus is on eligibility to participate in the group-based treatment, sleep-diagnostic evaluation, receive a standardized education on sleep-regulation and sleep hygiene advice and receive a date to start the group-based LT at gradually advanced timing. In a randomized manner, they will be allocated to the sleep-school group and start the treatment on the next possible date or to a 6 week wait-list and receive a date the treatment starts. All eligible participants will be informed that there may be a waitlist and receive a start-date without being informed that thay are on a waitlist group or not a waitlist group. All participants will be treated as usual (TAU) for their psychiatric problems parallel to either sleep-school or waitlist, hence both groups are in active treatment for their symptoms. Participants that start sleep-school as soon as possible, are also allocated to a) ordinary group-based LT at gradually advanced timing for 6 weeks or b) group-based group-based LT at gradually advanced timing for 6 weeks and bb-glasses. All participant will be followed up after 12 months.

• Changes in objective sleep onset latency (SOL) [Срок оценки: baseline and post intervention after 6 weeks, follow-up after 12 months]
• Changes in Sleep efficiency (SE) [Срок оценки: baseline, bi-weekly assesment and post intervention after 6 weeks, follow-up after 12 months]
• Changes in Time in bed (TIB) [Срок оценки: baseline, bi-weekly assesment and post intervention after 6 weeks, follow-up after 12 months]
• Changes in immediate sleepiness [Срок оценки: baseline, bi-weekly assesment and post intervention after 6 weeks, follow-up after 12 months]
• Changes in objective total sleep length/time asleep (TST) [Срок оценки: baseline and post intervention after 6 weeks, follow-up after 12 months]
• Work status [Срок оценки: baseline and post intervention after 6 weeks, follow-up after 12 months]
• Changes in Total sleep length/time asleep (TST) [Срок оценки: baseline, bi-weekly assesment and post intervention after 6 weeks, follow-up after 12 months]
• Changes in Early morning awakening (EMA) [Срок оценки: baseline, bi-weekly assesment and post intervention after 6 weeks, follow-up after 12 months]
• Changes in objective sleep efficiency (SE) [Срок оценки: baseline and post intervention after 6 weeks, follow-up after 12 months]
• Changes in objective early morning awakening (EMA) [Срок оценки: baseline and post intervention after 6 weeks, follow-up after 12 months]
• Changes in well-being [Срок оценки: baseline and post intervention after 6 weeks, follow-up after 12 months]
• Changes in sleepiness [Срок оценки: baseline, bi-weekly assesment and post intervention after 6 weeks, follow-up after 12 months]