A School-Based Sleep Education Program for Adolescents: A Cluster Randomized Trial

Wing, Yun Kwok; Chan, Ngan Yin; Yu, Manda; Lam, Siu Ping; Zhang, Jihui; Li, Shirley Xin; Kong, Alice Pik Shan; Li, Albert Martin

doi:10.1542/peds.2014-2419

Cited by 97 publications

(82 citation statements)

References 45 publications

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“…We therefore cannot say that improvements in any of our outcomes were due to our program, as opposed to a re-testing or expectation effect. It will be particularly important for future work to include a control group since the control groups of some previous randomized controlled trials of sleep education programs have demonstrated improvements in sleep knowledge and quality (20;21;28). Also, tracking sleep with a sleep diary may itself constitute an intervention on its own, perhaps because monitoring leads to changes in the perception of a sleep complaint(58), or because patients obtain insight by linking sleep habits with sleep quality and quantity, particularly among individuals with insomnia (59).…”

Section: Discussionmentioning

confidence: 99%

Pilot study of a sleep health promotion program for college students

et al. 2016

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Objectives We conducted a pilot study of a sleep health promotion program for college students. The aims of the study were to 1) determine the feasibility of the program, and 2) explore changes in sleep knowledge and sleep diary parameters. Design Open trial of a sleep health promotion program for college students. Setting A small liberal arts university in southwestern Pennsylvania Participants University students (primarily female). Intervention Active intervention components included individualized email feedback based on each participant’s baseline sleep diary and an in-person, group format presentation on sleep health. Measurements Participants completed online questionnaires and sleep diaries before and after the health promotion intervention. Online questionnaires focused on sleep knowledge and attitudes toward sleep, as well as Patient Reported Outcomes Measurement Information System (PROMIS) sleep and psychosocial assessments. Results Of participants who completed some aspect of the study, 89% completed at least one intervention component (in-person lecture and/or sleep diary). Participants reported significant improvement in sleep knowledge and changes in sleep diary parameters (decreased sleep onset latency and time spent in bed, resulting in greater sleep efficiency). Sleep duration also increased by 30 minutes among short sleepers who obtained <7 hours sleep at baseline. Conclusions Preliminary evaluation of a brief program to promote sleep health suggests that it is feasible and acceptable to implement, and that it can favorably alter sleep knowledge and behaviors reported on the sleep diary in college students. Controlled trials are warranted.

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Section: Discussionmentioning

confidence: 99%

Pilot study of a sleep health promotion program for college students

et al. 2016

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“…Inclusion criteria for iRBD probands included (1) diagnosis of video‐polysomnography (vPSG)‐confirmed iRBD, (2) onset of RBD symptoms in the absence of any preceding neurodegenerative disease, and (3) absence of comorbid narcolepsy. Non‐RBD control probands were recruited from the community (80% were recruited from the family members of a community‐based study in our Sleep Education Program) and our sleep clinic (20%). To minimize potential referral bias, recruitment of the majority of probands was intentionally community based.…”

Section: Methodsmentioning

confidence: 99%

A case–control–family study of idiopathic rapid eye movement sleep behavior disorder

Liu

Zhang

Lam

et al. 2019

Annals of Neurology

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Objective: To determine the familial aggregation of idiopathic rapid eye movement sleep behavior disorder (iRBD), neurodegenerative diseases, and related biomarkers. Methods: A total of 404 and 387 first-degree relatives of 102 patients with iRBD and of 89 controls were recruited, respectively. Among them, 204 and 208 relatives of patients and controls underwent face-to-face clinical assessment, whereas 97 and 75 relatives underwent further video-polysomnographic assessment, respectively. Results: Compared with relatives of controls, relatives of patients demonstrated higher levels of RBD features, including chin tonic electromyography activity (mean = 1.5 AE 7.5 vs 0.3 AE 1.0, p = 0.04) and behavioral events (n [weighted %] = 12 [11.3] vs 2 [1.9], adjusted hazard ratio [aHR] = 7.69, 95% confidence interval [CI] = 1.54-33.33, p = 0.009) during rapid eye movement sleep, probable diagnosis (n [%] = 57 [14.9] vs 20 [4.9], aHR = 3.45, 95% CI = 1.96-6.25, p < 0.001), and definite diagnosis (n [weighted %] = 10 [8.4] vs 2 [1.4], aHR = 5.56, 95% CI = 1.16-25.00, p = 0.03). They also had higher risks of Parkinson disease (3.1% vs 0.5%, aHR = 5.88, 95% CI = 1.37-25.00, p = 0.02), dementia (6.9% vs 2.6%, aHR = 2.44, 95% CI = 1.15-5.26, p = 0.02), constipation (8.3% vs 2.4%, adjusted odds ratio = 4.21, 95% CI = 1.34-13.17, p = 0.01), and motor dysfunction (Movement Disorders Society Unified Parkinson's Disease Rating Scale part III motor score, mean = 1.9 AE 3.2 vs 0.9 AE 2.3, p = 0.002). The unaffected relatives of patients demonstrated a higher likelihood ratio of prodromal Parkinson disease (median [interquartile range] = 0.27 [1.19] vs 0.22 [0.51], p = 0.03). Interpretation: iRBD is familially aggregated from isolated features to full-blown sleep disorder. Relatives of patients carry a higher risk of alpha-synucleinopathy in terms of neurodegenerative diseases and prodromal markers, suggesting a familial aggregation and staging pathology of alpha-synucleinopathy.

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“…[17][18][19] However, the magnitude of the effect size found in the current study was larger than those reported in RCTs of school-based sleep education programs. 70,71 This might be due to several factors. The Sleep SENSE interventions were personally tailored, more intensive, had a key focus on engagement and reviewing key information to increase retention and recall, and provided adequate opportunities to practice techniques in session and at home.…”

Section: Hypotheses One and Two-treatment Effectsmentioning

confidence: 99%

The SENSE Study: Treatment Mechanisms of a Cognitive Behavioral and Mindfulness-Based Group Sleep Improvement Intervention for At-Risk Adolescents

Blake¹,

Schwartz²,

Waloszek³

et al. 2017

Sleep

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Objectives:The aim of this study was to test whether a cognitive behavioral and mindfulness-based group sleep intervention would improve sleep and anxiety on school nights in a sample of at-risk adolescents. We also examined whether benefits to sleep and anxiety would be mediated by improvements in sleep hygiene awareness and presleep hyperarousal. Methods: Secondary analysis of a randomized controlled trial conducted with 123 adolescent participants (female = 60%; mean age = 14.48) who had high levels of sleep problems and anxiety symptoms. Participants were randomized into a sleep improvement intervention (n = 63) or active control "study skills" intervention (n = 60). Preintervention and postintervention, participants completed the Pittsburgh Sleep Quality Index (PSQI), Spence Children's Anxiety Scale (SCAS), Sleep Beliefs Scale (SBS), and Presleep Hyperarousal Scale (PSAS) and wore an actiwatch and completed a sleep diary for five school nights. Results: The sleep intervention condition was associated with significantly greater improvements in actigraphy-measured sleep onset latency (SOL obj ), sleep diary measured sleep efficiency (SE subj ), PSQI, SCAS, SBS, and PSAS, with medium to large effect sizes. Improvements in the PSQI and SCAS were specifically mediated by the measured improvements in the PSAS that resulted from the intervention. Improvements in SOL obj and SE subj were not specifically related to improvements in any of the putative treatment mechanisms. Conclusions:This study provides evidence that presleep arousal but not sleep hygiene awareness is important for adolescents' perceived sleep quality and could be a target for new treatments of adolescent sleep problems.

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A School-Based Sleep Education Program for Adolescents: A Cluster Randomized Trial

Cited by 97 publications

References 45 publications

Pilot study of a sleep health promotion program for college students

Pilot study of a sleep health promotion program for college students

A case–control–family study of idiopathic rapid eye movement sleep behavior disorder

The SENSE Study: Treatment Mechanisms of a Cognitive Behavioral and Mindfulness-Based Group Sleep Improvement Intervention for At-Risk Adolescents

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