The link between sleep disturbance and aggression among forensic psychiatric patients is well established. However, the relationship between subjective experience of sleep quality and sleep hygiene, reported head injury, age, neuropsychological functioning and risk within these populations remains poorly understood. A study is described examining the relationships between these factors in a sample of individuals deemed a “grave and immediate” risk toothers. The aim of this study is to explore these relationships in more detail.
A service evaluation project examining the prevalence of self-reported sleep dysfunction, age and the relationship with neuropsychological functioning, reported head injury and dynamic risk appraisals of a UK high secure psychiatric patient sample is described (n = 84).
Self-reported poor sleep quality and poor sleep hygiene is present among 65% of patients, especially those in admission and high dependency wards. Whilst there are no differences between those with a self-reported head injury history in sleep quality, there is in sleep hygiene. Older patients also report more sleep hygiene problems. The combination of poor sleep quality, poor sleep hygiene and performance within selective aspects of executive functioning tasks has some relationship with dynamic risk.
The importance of sleep management and cognitive remediation is discussed, as is the need for more robust research and inclusion of an assessment of sleep within forensic neuropsychological and psychiatric evaluations.
To the best of the authors’ knowledge, this is the first study to examine the relationship of sleep disturbance, neuropsychological functioning and head injuries and risk within a high secure psychiatric patient sample.
