Cognitive Behavioral Treatment for Improving Sleep in Overweight and Obese Youth

改善超重和肥胖青少年睡眠的认知行为治疗

• 批准号: 8920163
• 负责人: DAVID M JANICKE
• 金额: $ 17.3万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-02 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8920163
• 关键词: Address; Aftercare; Age; Beds; Behavior; Behavior Therapy; Behavioral; Body Weight Changes; Body Weight decreased; Body mass index; Caffeine; Child; Child Rearing; Child health care; Childhood; Clinic; Clinical; Cognitive; Cognitive Therapy; Communities; Comorbidity; Cues; Data; Desire for food; Development; Diagnosis; Diet; Dietary intake; Eating; Education; Evaluation; Exhibits; Family; Family Characteristics; Family health status; Fatigue; Food; Health; Health Benefit; Healthy People 2020; Height; Hormonal; Impairment; Inadequate Sleep Hygiene; Individual; Insufficient Sleep Syndromes; Intervention; Interview; Lead; Life Style; Literature; Mediator of activation protein; Metabolic; Metabolism; Moods; Motivation; Obesity; Outcome; Overweight; Oxygen; Parents; Participant; Patients; Pattern; Physical activity; Polysomnography; Population; Populations at Risk; Problem behavior; Process; Public Health; Quality of life; Randomized; Randomized Controlled Trials; Recruitment Activity; Research; Research Personnel; School-Age Population; Sleep; Sleep Apnea Syndromes; Sleep Disorders; Sleep disturbances; Sleeplessness; Staging; Testing; Time; Treatment outcome; Universities; Vulnerable Populations; Weight; Weight Gain; Weight maintenance regimen; Work; Youth; base; coping; diaries; diet and exercise; fight against; follow-up; healthy lifestyle; high risk; improved; lifestyle intervention; obesity in children; obesity risk; research study; screening; secondary outcome; sugar

DESCRIPTION (provided by applicant): Childhood obesity represents a major threat to public health. Sleep disturbance represents a significant comorbidity for overweight and obese (OV/OB) youth [(ages 6-12)] potentially contributing to a variety of negative consequences (lower quality of life, metabolic abnormalities) and further weight gain in this vulnerable population. Lack of sleep may contribute to increased weight status via reduced physical activity caused by fatigue; increased food intake caused by more opportunity to eat; cognitive, behavioral or mood impairments; and changes in metabolism that impact appetite or allow the body to conserve energy. Behavioral sleep disorders are more common in OV/OB youth than in general pediatric populations, with approximately 2 out of 3 OV/OB youth having significant problematic sleep behaviors. Behavioral interventions to address behavioral sleep disorders in children are efficacious in improving sleep in very young children. Improving sleep in OV/OB youth may enhance weight outcomes as improved sleep can lead to changes in energy, mood, appetite, motivation, and cues to eat that can augment a behavioral weight management intervention. Unfortunately, no research to date has examined the efficacy of cognitive behavioral treatment for child sleep (CBTcs) to address [behavioral sleep disorders (inadequate sleep hygiene, insufficient sleep syndrome, and insomnia)] in school-aged youth, nor exclusively in OV/OB youth. Preliminary evidence from our team suggests CBTcs holds great promise to improve sleep outcomes in OV/OB youth. However, more methodologically rigorous evaluation that also includes preliminary evaluation of secondary outcomes that could impact long-term weight status outcomes is needed. Thus, as the logical next step in this line of research, we propose to conduct a randomized controlled trial (RCT) that evaluates the efficacy of brief CBTcs to improve sleep in an important high-risk population, OV/OB youth with behavioral sleep disorders. OV/OB youth [(ages 6-12)] with behavioral sleep disorders (n = 60) and their parent(s) will be randomly assigned to [8 sessions] of either CBTcs or an [Educational Control (EC). CBTcs will address behavioral sleep issues in children; EC will address sleep and dietary education and general coping strategies.] Child sleep (total wake time, total sleep time, bed/wake times), height, weight, physical activity, dietary intake, quality of life (QOL), fatigue, and daytime sleepiness will be assessed at baseline, post-treatment, and 3-month follow-up.

描述（由申请人提供）：儿童肥胖是对公共健康的主要威胁。睡眠障碍是超重和肥胖（OV/OB）青少年[（6-12岁）]的一种重要合并症，可能导致该弱势人群的各种负面后果（生活质量降低、代谢异常）和进一步体重增加。睡眠不足可能会导致体重增加，原因是疲劳导致的体力活动减少;更多的进食机会导致的食物摄入量增加;认知，行为或情绪障碍;以及影响食欲或允许身体保存能量的新陈代谢变化。行为睡眠障碍在OV/OB青少年中比一般儿科人群更常见，大约3个OV/OB青少年中有2个有严重的睡眠行为问题。针对儿童行为性睡眠障碍的行为干预在改善幼儿睡眠方面是有效的。改善OV/OB青少年的睡眠可能会提高体重结果，因为改善睡眠可以导致能量，情绪，食欲，动机和进食线索的变化，从而增加行为体重管理干预。不幸的是，迄今为止还没有研究检查儿童睡眠认知行为治疗（CBTcs）的有效性，以解决学龄青年的[行为睡眠障碍（睡眠卫生不足，睡眠不足综合征和失眠）]，也不完全是OV/OB青年。我们团队的初步证据表明，CBTcs在改善OV/OB青年的睡眠结果方面具有很大的潜力。然而，还需要更严格的方法学评估，包括可能影响长期体重状态结果的次要结果的初步评估。因此，作为这一系列研究的逻辑下一步，我们建议进行一项随机对照试验（RCT），评估简短CBTcs改善重要高危人群（患有行为睡眠障碍的OV/OB青少年）睡眠的疗效。患有行为睡眠障碍的OV/OB青少年[（6-12岁）]（n = 60）及其父母将被随机分配至CBTC或教育对照（EC）的[8个疗程]。CBTC将解决儿童的行为睡眠问题; EC将解决睡眠和饮食教育以及一般应对策略。儿童睡眠（总清醒时间、总睡眠时间、上床/清醒时间）、身高、体重、体力活动、饮食摄入、生活质量（QOL）、疲劳、 在基线、治疗后和3个月随访时评估日间嗜睡。