A cognitive-behavioral and mindfulness-based group sleep intervention improves behavior problems in at-risk adolescents by improving perceived sleep quality

Nov 5, 2017Behaviour research and therapy

Group sleep training using thinking and mindfulness skills improves behavior by helping at-risk teens feel they sleep better

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Abstract

Improvements in self-reported sleep quality were associated with reductions in behavior problems among 123 at-risk adolescents.

Postintervention improvements in social problems, attention problems, and aggressive behaviors were linked to enhancements in perceived sleep quality.
The changes in behavior were not associated with objective measures of sleep, such as sleep onset latency or sleep efficiency.
The intervention involved a cognitive-behavioral and mindfulness-based approach specifically designed for improving sleep.
Participants were primarily adolescents aged 12 to 16 years, with high levels of sleep problems and anxiety symptoms.
The findings support the potential of sleep interventions to address behavioral issues in adolescents.

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OBJECTIVE: The aim of this study was to test whether a cognitive-behavioral and mindfulness-based group sleep intervention would improve behavior problems in at-risk adolescents, and whether these improvements were specifically related to improvements in sleep.

METHOD: Secondary analysis of a randomized controlled trial conducted with 123 adolescent participants (female = 60%; mean age = 14.48, range 12.04-16.31 years) who had high levels of sleep problems and anxiety symptoms. Participants were randomized into either a sleep improvement intervention (n = 63) or an active control "study skills" intervention (n = 60). Participants completed sleep and behavior problems questionnaires, wore an actiwatch and completed a sleep diary for five school nights, both before and after the intervention.

RESULTS: Parallel multiple mediation models showed that postintervention improvements in social problems, attention problems, and aggressive behaviors were specifically mediated by moderate improvements in self-reported sleep quality on school nights, but were not mediated by moderate improvements in actigraphy-assessed sleep onset latency or sleep diary-measured sleep efficiency on school nights.

CONCLUSION: This study provides evidence, using a methodologically rigorous design, that a cognitive-behavioral and mindfulness-based group sleep intervention improved behavior problems in at-risk adolescent by improving perceived sleep quality on school nights. These findings suggest that sleep interventions could be directed towards adolescents with behavior problems.

CLINICAL TRIAL REGISTRATION: This study was part of The SENSE Study (Sleep and Education: learning New Skills Early). URL: ACTRN12612001177842; http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=ACTRN12612001177842&isBasic=True.

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A cognitive-behavioral and mindfulness-based group sleep intervention improves behavior problems in at-risk adolescents by improving perceived sleep quality

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