Results From an Integrative Behavioral Sleep-Treatment Pilot Program

Abstract

Study Objectives: To examine whether change in total sleep time during an integrative, behavioral sleep intervention is associated with aggression. Specifically, we tested whether adolescents who reported experiencing aggressive thoughts or actions after treatment had worse treatment trajectories (e.g., less total sleep time across treatment) than adolescents with no aggressive thoughts or actions after treatment. Design: Nonpharmacologic open trial with 9 weeks of weekly assessment. Setting: University of Arizona Sleep Research Laboratory Patients or Participants: Twenty-three adolescents recently treated for substance abuse in outpatient community centers. Intervention: Six-week integrative, behavioral sleep intervention. Measurements and Results: Weekly sleep-summary indexes were calculated from daily sleep diaries and entered as dependent variables in a series of growth-curve analyses. Statistically significant Session × Post-treatment Aggressive Ideation interactions emerged when predicting changes in total sleep time, γ13 = 9.76 (SE = 4.12), p < .05, and time spent in bed, γ13 = 10.08,(SE = 4.33), p < .05, even after controlling for aggressive ideation and the frequency of substance use, as assessed at baseline. A similar pattern of results was seen for self-reported aggressive actions occurring during conflicts. Conclusions: These pilot data suggest that inadequate sleep in substance-abusing adolescents may contribute to the experiencing of aggressive thoughts and actions. Limitations include a small sample size and a restricted assessment of aggression. Nonetheless, these findings lend preliminary support to the breadth of therapeutic effectiveness of an integrative, behavioral sleep-therapy program for adolescents with a history of substance abuse and related behaviors. Citation: Haynes PL; Bootzin RR; Smith L et al. Sleep and aggression in substance-abusing adolescents: results from an integrative behavioral sleep-treatment pilot program. SLEEP 2006;29(4): 512-520.

Is there an association between insomnia symptoms, aggressive behavior, and suicidality in adolescents?

“…Contrary to our expectations and the results of other studies, 13 – 15 , 35 the amount of aggressive behavior did not significantly differ between good and poor sleeping adolescents. However, it is necessary to keep in mind that the results of previous studies on the relationship between sleep problems and aggression/aggressive behavior were based on data from special populations (eg, Haynes et al, 13 and Ireland and Culpin 14 ).…”

“…Only a few studies with specific populations have examined the connection between aggression and sleep in adolescents. Haynes et al 13 examined a sample of 23 (57% male) adolescents aged 13–19 years who had recently successfully completed substance abuse treatment. The authors’ interest was focused on assessing whether aggression was associated with a change in total sleep time during the course of behavioral sleep treatment.…”

“…Adolescents who reported more aggression ideation also reported less total sleep time and less time in bed than adolescents showing less aggressive actions. 13 When controlling for baseline aggression and frequency of substance abuse, there was still a link between the insufficient amount of sleep and aggressive behavior occurring later in adolescents. The authors concluded that successful sleep-problem treatment could be a crucial element in violence prevention.…”

“…Furthermore, they stated that inadequate sleep led to a possible predisposition in adolescents for affective and behavioral disinhibition. 13 …”

Biobehavioral Approaches to Aggression Implicate Perceived Threat and Insufficient Sleep: Clinical Relevance and Policy Implications

“…Considering that sufficient sleep facilitates learning (Stickgold, 2005), treating sleep concerns with psychotherapeutic and pharmacological approaches can help clients attempting to learn new skills and establish less habitual patterns. In support, treating sleep disturbances diminishes aggression (Haynes et al, 2006; Pakyurek, Gutkovich, & Weintraub, 2002).…”