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Sleep disturbances affect up to 70% of individuals with serious mental illness (SMI), with insomnia prevalence in incarcerated populations ranging from 26-72% and poor sleep quality reported in up to 88% of individuals in the prison setting. This session addresses the unique challenges of managing sleep disorders in locked state hospitals and correctional facilities, where environmental factors (noise, lighting, security checks) compound psychiatric comorbidities. Participants will examine evidence supporting cognitive behavioral therapy for insomnia (CBT-I) as first-line treatment, including adaptations for inpatient psychiatric settings. The session covers pharmacological considerations specific to SMI populations, including efficacy data for licensed and off-label agents. Practical implementation strategies for creating sleep-promoting environments within security constraints will be discussed, along with treatment algorithms. Special attention is given to the bidirectional relationship between sleep and psychiatric symptoms and how sleep improvement may enhance treatment of psychosis, depression, and suicidality.