Sustainable Habits for Encouraging Even Teen Sleep (SHEETS): A Digital Intervention to Enhance Sleep Regularity and Psychiatric Health in Adolescents

超过三分之二的美国青少年表现出不健康的睡眠模式。睡眠，这是一个结构， RDoC的唤醒和调节域，是一个支持精神健康的关键过程， 青春期具体来说，睡眠障碍似乎代表了一个跨诊断的风险因素， 内化和外化障碍，以及干扰学术和社会表现，在此期间， 关键发展期。因此，改善青少年睡眠的预防性干预措施是 支持精神健康和整个生命周期的功能。有效的行为睡眠 为青少年制定了战略。然而，对于已知的在 从研究和专科护理机构到社区预防和初级保健实践机构， 大多数青少年获得社会和保健服务。同样，初级保健中的许多预期指导 侧重于睡眠时间，这可能是很难改善后，青少年导航多个学术 和课外活动相反，睡眠的另一个重要方面，睡眠-觉醒模式的规律性， 与一系列精神健康和功能结果相关，这些关系被证明是 与持续时间无关，提示增强睡眠规律性可改善青少年精神 即使持续时间保持不变。认识到睡眠、精神疾病和 健康和心理社会功能，迫切需要采取有效的行为策略来改善 年轻人的睡眠规律，并优化提供系统，以在初级保健中覆盖不同的年轻人 环境是大多数青年寻求情感和心理健康支持的切入点。拟议 项目，我们将评估6周数字睡眠规律干预的可行性和可接受性 （鼓励青少年睡眠的可持续习惯; SHEETS）在不同的青少年人群中， 年龄在13-15岁之间，并将探索一系列与睡眠规律有关的社会环境驱动因素， 采取干预措施。SHEETS使用数字平台提供关于睡眠规律的教育， 预防工具，激励信息，支持为一致的睡眠和觉醒时间设定目标， 监测.可穿戴睡眠传感器（Garmin手表）为青少年提供实时反馈， 睡眠规律。我们还将评估SHEETS对睡眠规律，睡眠 实践和精神卫生（即，内化和外化症状，心理社会功能） 在初级保健儿科实践中接受卫生服务的青少年与积极的对照组相比， 并将探索睡眠规律作为SHEETS参与和更好地 精神健康这项研究的结果将为制定一项有足够动力的 随机对照试验（RCT）旨在优化和评估可扩展的，易于传播的数字睡眠 对生活在各种社会文化环境中的青年来说，干预措施是可接受的和有效的。

More than two-thirds of U.S. adolescents exhibit unhealthy sleep patterns. Sleep, which is a construct in the Arousal and Regulatory domain of RDoC, is a critical process supporting psychiatric health during adolescence. Specifically, sleep disturbances appear to represent a transdiagnostic risk factor for onset of internalizing and externalizing disorders as well as interfere with academic and social performance during this critical developmental period. Thus, preventative interventions to improve sleep among adolescents are necessary to support psychiatric health and functioning across the lifespan. Efficacious behavioral sleep strategies exist for adolescents. However, there has been limited translation of what is known to work in research and subspecialty care settings to community preventive and primary care practice settings, where most adolescents access social and health services. As well, much of the anticipatory guidance in primary care focuses on sleep duration, which may be difficult to improve upon for adolescents navigating multiple academic and extracurricular demands. In contrast, another critical aspect of sleep, the regularity of sleep-wake patterns, is associated with a range of psychiatric health and functional outcomes, and these relationships are shown to be independent of duration, suggesting enhancing sleep regularity may improve adolescent psychiatric outcomes even if duration remains constant. Recognizing the powerful connections between sleep, psychiatric wellness, and psychosocial function, there is a critical need to take efficacious behavioral strategies to improve sleep regularity among youth, and to optimize the delivery system to reach diverse youth in the primary care setting, the point of access for most youth seeking support for emotional and mental health. For the proposed project, we will evaluate the feasibility and acceptability of a 6-week digital sleep regularity intervention (Sustainable Habits for Encouraging Even Teen Sleep; SHEETS) among a diverse population of adolescents, ages 13-15 years, and will explore a range of socio-environmental drivers of sleep regularity as they relate to intervention uptake. SHEETS uses a digital platform to deliver education on sleep regularity as a health prevention tool, motivational messaging, support for setting goals for consistent bed- and wake-times, and self- monitoring. Wearable sleep sensors (Garmin wristwatches) provide real-time feedback to adolescents about their sleep regularity. We will also evaluate the short-term effectiveness of SHEETS on sleep regularity, sleep practices, and psychiatric health (i.e., internalizing and externalizing symptoms, psychosocial function) among adolescents receiving health services in a primary care pediatric practice compared to an active control group, and will explore sleep regularity as a mediator of the relationship between SHEETS participation and better psychiatric health. Findings from this study will inform proposal development for an adequately-powered randomized controlled trial (RCT) designed to optimize and evaluate scalable, easily disseminated digital sleep interventions that are acceptable and effective for youth living in a range of sociocultural contexts.