Management of sleep complaints

Abstract Sleep problems are commonly experienced by both persons in the community and those who are incarcerated. Up to 88% of persons in jails and prisons report having poor sleep quality. Contributing factors include poor sleeping habits, preexisting or emergent mental health symptoms, substance use, and the conditions of confinement. Excess time in cell, long periods of inactivity, and a lack of physical activity are important modifiable factors in a correctional environment. Improving the conditions of confinement has been shown to decrease prescription of sleep medication and to promote better daytime functioning. Evidence-based management includes an adequate assessment; improving the conditions of confinement; offering evidence-based nonpharmacological options such as cognitive-behavioral therapy, sleep hygiene education, and relaxation and meditation techniques; and offering pharmacological treatments, including benzodiazepines for acute insomnia, when indicated. The effective management of sleep complaints in correctional settings is consistent with ethical medical practice and will improve outcomes for patients and the facilities in which they reside.