Effects of a single session intervention on actigraphy-measured sleep for adolescents with insufficient and irregular sleep: A randomized controlled trial.

INTRODUCTION

We previously developed a brief, behavioral intervention (Sleep Promotion Program, SPP) that demonstrated feasibility, acceptability, and increased self-reported sleep. Here, we tested the effects of SPP on the trial's secondary outcomes: sleep duration, regularity, and timing as measured by actigraphy and conducted a secondary analysis of SPP's effects on rest-activity rhythms.

METHODS

Forty participants (ages 13-15) with insufficient and irregular sleep randomized to SPP-continuation (n = 22), or to sleep monitoring-SPP (n = 18), had analyzable actigraphy data. SPP included sleep psychoeducation and one individual clinician session. Participants wore an actigraph for 1-2 weeks during baseline, Period 1, and Period 2. We hypothesized SPP would lead to longer and more regular sleep from baseline to Period 1 compared to sleep monitoring that would be sustained at Period 2. We used multilevel models with a treatment by time interaction to test whether SPP improved sleep relative to sleep monitoring. We also compared sleep changes from Period 1 to Period 2 among participants randomized to SPP-continuation.

RESULTS

Participants receiving SPP decreased the difference in weekend-weekday sleep onset by 54-minute (β = 1.1; p = .03) from baseline to Period 1 (i.e., increased regularity). Increased regularity was maintained at Period 2. Total sleep time did not change significantly.

CONCLUSION

SPP regularized weekend-weekday sleep onset timing in adolescents with insufficient and irregular sleep but did not change actigraphic sleep duration, which differed from increases in self-reported sleep duration previously reported. Regularizing sleep may be an attainable first step to improving adolescent sleep. Future work is needed to test whether sleep regularity predicts adolescent health outcomes.

CLINICAL TRIALS: Targeted Intervention for Insufficient Sleep among Typically-Developing Adolescents (TAPAS); https://clinicaltrials.gov/ct2/show/NCT04163003; NCT04163003.