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: 9121605
• 负责人: Stephanie Crowley McWilliam
• 金额: $ 63.8万
• 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/9121605
• 关键词: Adherence; Adolescent; Adoption; Alcohol consumption; Anxiety; Behavior; Behavior Therapy; Biological; Boxing; Child; Circadian Rhythms; 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; Phototherapy; 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; cognitive process; emotion regulation; executive function; experience; falls; follow-up; high school; improved; neurobehavioral; novel; processing speed; 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健康人2020的主要健康行为目标之一。年龄较大（高中）的青少年特别容易受到睡眠不足的影响，因为青春期对睡眠调节（睡眠体内平衡和昼夜节律）的改变越来越倾向于在傍晚和夜间保持清醒，这使得早期睡眠变得困难，而这些生理变化与高中早期开学时间相吻合。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冲突。在美国，大约80%到90%的大龄青少年报告说，他们在上学的晚上平均比建议少睡1到2个小时。睡眠不足与许多负面结果有关，包括抑郁情绪和自杀意念的风险增加、决策能力差、学习成绩差和肥胖。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。这一申请是对PA-11-063的回应，PA-11-063呼吁“……开发和改进新的健康相关行为干预措施，特别是针对健康行为的采用或维持。”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，并为夜间睡眠不足风险最大的青少年（高中学生）提供课后活动的时间管理计划，以增加夜间在校睡眠时间。研究1（干预发展）将检查两种不同持续时间（30分钟和90分钟）的早晨强光与室内光（一个周末在实验室测试）的有效性和可接受性。我们将根据实验室收集的青少年的新数据来确定明亮光线的时间。我们将在研究2（干预概念的证明）中使用研究1的结果，研究2利用在实验室度过的一个周末的晨光。周末的起床时间——以及明亮的光线的开始——和就寝时间将提前，以推进昼夜节律系统，从而在接下来的学校周中促进更早的睡眠。学校还将实施一项夜间时间管理计划，以促进提早就寝。研究人员将在干预前后立即测量昼夜节律阶段、睡眠、神经行为功能和情绪，并与对照组进行比较。对照组在家中保持正常的睡眠时间表，周末不来实验室接受强光治疗，也不接受任何课后时间管理指导。长期效果将在三周的维持期后进行检验，在此期间，青少年将被要求遵循他们更早、更长时间的睡眠时间表，并在周末早晨在家偶尔使用明亮的光线。将评估干预措施的依从性和可接受性。这些数据将为睡眠迟缓和睡眠受限的青少年提供循证治疗策略，以及该年龄组治疗的可接受性和依从性。