Teen School-Night Sleep Extension: An Intervention Targeting the Circadian System

青少年学校晚上的睡眠延长：针对昼夜节律系统的干预措施

• 批准号: 8759958
• 负责人: Stephanie Crowley McWilliam
• 金额: $ 61.99万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8759958
• 关键词: Adherence; Adolescent; Adoption; Alcohol consumption; Anxiety; Behavior; Behavior Therapy; Biological; Boxing; Child; Circadian Rhythms; Cognitive; Conflict (Psychology); Control Groups; Cues; Data; Decision Making; Depressed mood; Development; Disease; Drug usage; Effectiveness; Effectiveness of Interventions; Evidence based treatment; Feeling suicidal; Health; Health behavior; Healthy People 2020; High School Student; Home environment; Homeostasis; Human; Institute of Medicine (U.S.); Instruction; Intervention; Learning; Life; Light; Maintenance; Mammals; Measures; Melatonin; Moods; Obesity; Outcome; Outcome Measure; Overweight; Participant; Performance; Personal Satisfaction; Phase; Problem Solving; Psychosocial Factor; Puberty; Reporting; Research Project Grants; Risk; Risk Behaviors; Risk-Taking; Schedule; School-Age Population; Schools; Sleep; Sleep Disorders; Stimulus; System; Teenagers; Testing; Time; Time Management; age group; aged; alertness; automobile accident; base; emotion regulation; executive function; experience; falls; follow-up; high school; improved; light treatment; neurobehavioral; novel; processing speed; public health relevance; response; sleep onset; sleep regulation; social; therapy development; treatment strategy

DESCRIPTION (provided by applicant): The Institute of Medicine identified sufficient sleep as one of the leading health behavior objectives for Healthy People 2020. Older (high-school-aged) adolescents are especially vulnerable to insufficient sleep as pubertal changes to sleep regulation (sleep homeostasis and circadian timing) increasingly favor alertness later into the evening and night, making an early sleep onset difficult, and these biological changes coincide with early high school start times. Thus, many high schoolers (aged 14-17 years) are faced with a conflicting biological drive to fall asleep late and a social drive to wake early for school. Approximately 80 to 90% of older adolescents in the U.S. report an average of 1 to 2 h less sleep than recommended on school nights. Sleep restriction is associated with many negative outcomes, including an increased risk for depressed mood and suicidal ideation, poor decision making, poor academic grades, and obesity. The broad objective of this project is to develop an effective, yet feasible intervention to extend school-night sleep duration of older adolescents. This application is in response to PA-11-063, which calls for "...developing and refining novel health-related behavioral interventions specifically targeting adoption or maintenance of health behavior." We propose to develop and test a feasible behavioral intervention to increase school-night sleep duration by advancing the circadian system and providing a time management plan for after-school activities in youngsters most at risk for insufficient school-night sleep - high school students who experience difficulties falling asleep at a desired early time on school nights. Study 1 (intervention development) will examine effectiveness and acceptability of two different durations (30 mins & 90 mins) of morning advancing bright light compared to room light (tested in the lab on one weekend). We will time the bright light based on new data from adolescents collected in our lab. We will use the results of Study 1 in Study 2 (proof of intervention concept), which utilizes morning bright light on one weekend spent in the lab. Weekend wake time - and the start of bright light - and bedtime will shift earlier to advance the circadian system to facilitate earlier sleep onset during the subsequent school week. A school-night time management plan will also be implemented to facilitate these earlier bedtimes. Circadian phase, sleep, neurobehavioral functioning and mood will be measured before and immediately after the intervention and compared to a control group who keeps their usual sleep schedules at home, does not come to the lab for weekend bright light treatment, and is not given any after-school time-management instruction. Long-term effectiveness will be examined after a 3-week maintenance period, during which adolescent will be instructed to follow their earlier and longer sleep schedule and use occasional bright light on weekend mornings at home. Adherence and acceptability of the intervention will be assessed. These data will provide evidence-based treatment strategies for delayed and sleep-restricted adolescents, and acceptability of and adherence to the treatment in this age group.

描述(由申请人提供)：医学研究所将充足的睡眠确定为2020年健康人的主要健康行为目标之一。年龄较大的(高中生)青少年尤其容易受到睡眠不足的影响，因为青春期对睡眠调节(睡眠平衡和昼夜节律)的改变越来越倾向于在晚上晚些时候和晚上保持警觉，使得早睡变得困难，这些生物学变化与高中早期开始时间不谋而合。因此，许多高中生(14-17岁)面临着晚睡的生理动力和早起上学的社会动力的矛盾。在美国，大约80%到90%的年龄较大的青少年报告说，在上学的晚上，他们的睡眠时间平均比建议的少1到2小时。睡眠限制与许多负面后果有关，包括情绪低落和自杀念头的风险增加、糟糕的决策、糟糕的学业成绩和肥胖。该项目的总体目标是开发一种有效而可行的干预措施，以延长年龄较大的青少年的在校夜间睡眠时间。这项申请是对PA-11-063的响应，PA-11-063呼吁“……开发和改进专门针对健康行为的采用或维持的与健康相关的新的行为干预措施。”我们建议开发和测试一种可行的行为干预措施，通过推进昼夜节律系统，并为最有可能在学校夜间睡眠不足的高中生提供课外活动的时间管理计划，来增加学校夜间睡眠时间。研究1(干预发展)将检验两种不同持续时间(30分钟和90分钟)的晨光与房间光(一个周末在实验室测试)的有效性和可接受性。我们将根据在我们实验室收集的青少年的新数据来计算亮光的时间。我们将在研究2(干预概念的证明)中使用研究1的结果，该研究利用在实验室度过的一个周末的早晨的明亮光线。周末的起床时间和入睡时间将会提前，从而使生物钟系统提前，以便在接下来的一周里更早入睡。此外，当局亦会实施夜间上课时间管理计划，以方便提早就寝时间。将在干预之前和之后立即测量昼夜节律、睡眠、神经行为功能和情绪，并将其与控制组进行比较，控制组的人通常在家里保持睡眠时间表，不来实验室进行周末强光治疗，也不接受任何课后时间管理指导。长期效果将在为期3周的维持期后进行测试，在此期间，青少年将被指导遵循他们更早和更长的睡眠时间表，并在周末早上在家中偶尔使用明亮的灯光。将评估干预措施的坚持性和可接受性。这些数据将为延迟和睡眠受限的青少年提供循证治疗策略，以及该年龄段对治疗的接受和坚持。