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 RDoC的觉醒和调节域，是支持精神健康的关键过程 青春期。具体地说，睡眠障碍似乎代表了一种跨诊断的危险因素，可导致 将障碍内化和外化，并在此期间干扰学习和社交表现 关键发育期。因此，改善青少年睡眠的预防性干预措施是 这是支持精神健康和终生功能所必需的。有效的行为睡眠 针对青少年的策略是有的。然而，对已知在以下方面起作用的内容的翻译一直有限 研究和专科护理环境到社区预防和初级保健实践环境，其中 大多数青少年都能获得社会和卫生服务。此外，初级保健中的大部分预期指导 重点放在睡眠时间上，这可能很难改善青少年导航多个学术 和课外要求。相比之下，睡眠的另一个关键方面，睡眠-觉醒模式的规律性， 与一系列精神健康和功能结果有关，这些关系被证明是 与持续时间无关，这表明加强睡眠规律可能会改善青少年的精神状况 结果，即使持续时间保持不变。认识到睡眠和精神疾病之间的强大联系 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 青年的睡眠规律，并优化提供系统，以覆盖初级保健中的不同青年 在这一背景下，大多数寻求情感和心理健康支持的青年都能找到切入点。对于建议的 项目中，我们将评估为期6周的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；床单)在不同的青少年群体中， 年龄13-15岁，并将探索一系列与睡眠规律有关的社会环境驱动因素 干预摄取。Sheet使用一个数字平台提供关于睡眠规律的健康教育 预防工具、激励性信息、支持设定一致的睡醒时间目标，以及自我 监控。可穿戴的睡眠传感器(Garmin手表)为青少年提供关于 他们的睡眠规律。我们还将评估床单对睡眠规律性、睡眠的短期效果 实践和精神健康(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控制组进行比较， 并将探索睡眠规律作为床单参与度与更好关系的中介变量 精神健康。这项研究的发现将为制定一个动力充足的 旨在优化和评估可扩展、易于传播的数字睡眠的随机对照试验(RCT) 对生活在各种社会文化背景下的青年采取可接受和有效的干预措施。

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.