The SENSE Study: Treatment Mechanisms of a Cognitive Behavioral and Mindfulness-Based Group Sleep Improvement Intervention for At-Risk Adolescents
The SENSE Study: Treatment Mechanisms of a Cognitive Behavioral and Mindfulness-Based Group Sleep Improvement Intervention for At-Risk Adolescents
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DOI：
10.1093/sleep/zsx061
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发表时间：
2017-06-01
期刊：
影响因子：
5.6
通讯作者：
Allen, Nicholas B.
中科院分区：
文献类型：
--
作者：
Blake, Matthew;Schwartz, Orli;Allen, Nicholas B.
目的：本研究的目的是测试基于认知行为和正念的团体睡眠干预是否会改善高危青少年样本在学校晚上的睡眠和焦虑。我们还研究了睡眠卫生意识和睡前过度唤醒是否会改善睡眠和焦虑。方法：对 123 名患有严重睡眠问题和焦虑症状的青少年参与者（女性 = 60%；平均年龄 = 14.48）进行的随机对照试验进行二次分析。参与者被随机分为睡眠改善干预组（n = 63）或主动控制“学习技能”干预组（n = 60）。干预前和干预后，参与者完成了匹兹堡睡眠质量指数 (PSQI)、斯彭斯儿童焦虑量表 (SCAS)、睡眠信念量表 (SBS) 和睡前过度觉醒量表 (PSAS)，并佩戴 Actiwatch 并完成了五个上学夜晚的睡眠日记。 结果：睡眠干预条件与体动记录仪测量的入睡潜伏期 (SOL obj)、睡眠日记的显着改善相关测量睡眠效率 (SE subj)、PSQI、SCAS、SBS 和 PSAS，效应大小为中等到大。 PSQI 和 SCAS 的改善具体是通过干预导致的 PSAS 测量改善来调节的。 SOL obj 和 SE subj 的改善与任何假定的治疗机制的改善都没有具体关系。 结论：这项研究提供的证据表明，睡前觉醒而非睡眠卫生意识对青少年感知的睡眠质量很重要，并且可能成为青少年睡眠问题新治疗的目标。
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.