A patient first perspective of sleep disturbance across therapeutic areas: a systematic literature review of qualitative studies

Abstract

Background: Sleep, a vital pillar of health, impacts daily functioning and overall quality of life. Despite extensive research on sleep disturbances within specific therapeutic areas (TAs), there's limited understanding of how these disturbances affect patients across multiple TAs. This systematic literature review adopts a patient-centered approach to explore the meaningful aspects of health and concepts of interest relating to sleep and sleep disturbances across a variety of TAs, utilizing qualitative research to bridge the gap between patient experiences and clinical measures. Methods: A systematic search was conducted in Embase and PubMed for qualitative studies on sleep within selected TAs, using a pre-registered strategy. Initial screenings based on titles and abstracts were followed by full-text reviews and quality appraisal using the CASP checklist. Results: From 4331 unique publications, 52 full-text articles were analyzed across 11 TAs. Thematic analysis highlighted issues within the sleep window, and proximal and distal impacts of sleep disturbances. Using thematic analysis a conceptual model was developed, illustrating a multitude of sleep disturbances from a patient-first perspective, which emphasized sleep quality's role in daily functionality. Discussion: This review emphasizes the importance of incorporating patient perspectives into sleep research and clinical practice. By presenting a holistic conceptual model, it provides a foundation for developing outcome measures that reflect meaningful aspects of patients' sleep experiences. This patient-centered approach highlights the need for novel methodologies in sleep research, beyond traditional clinical outcome assessments, to capture the full spectrum of sleep disturbances' impacts on patients' lives across various TAs.