Systematic Review and Meta-analysis of Adolescent Cognitive–Behavioral Sleep Interventions

Mar 24, 2017Clinical child and family psychology review

Summary and combined analysis of sleep therapy using thinking and behavior methods for teenagers

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Abstract

Subjective total sleep time improved by 29.47 minutes following adolescent cognitive-behavioral sleep interventions.

Sleep onset latency showed a reduction of 21.44 minutes post-intervention.
Sleep efficiency increased by 5.34% based on subjective measures.
Wake after sleep onset demonstrated a medium effect size improvement.
Objective measures indicated a 16.15-minute reduction in sleep onset latency.
Global sleep quality, daytime sleepiness, depression, and anxiety also improved.
Gains in sleep parameters were generally maintained over time.

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This systematic review and meta-analysis examined the efficacy of adolescent cognitive-behavioral sleep interventions. Searches of PubMed, PsycINFO, CENTRAL, EMBASE, and MEDLINE were performed from inception to May 1, 2016, supplemented with manual screening. Nine trials were selected (n = 357, mean age = 14.97 years; female = 61.74%). Main outcomes were subjective (sleep diary/questionnaire) and objective (actigraphy) total sleep time (TST), sleep onset latency (SOL), sleep efficiency (SE), and wake after sleep onset (WASO). There were a small number of randomized controlled trials (RCTs; n = 4) and a high risk of bias across the RCTs; therefore, within sleep condition meta-analyses were examined (n = 221). At post-intervention, subjective TST improved by 29.47 min (95% CI 17.18, 41.75), SOL by 21.44 min (95% CI -30.78, -12.11), SE by 5.34% (95% CI 2.64, 8.04), and WASO by a medium effect size [d = 0.59 (95% CI 0.36, 0.82)]. Objective SOL improved by 16.15 min (95% CI -26.13, -6.17) and SE by 2.82% (95% CI 0.58, 5.07). Global sleep quality, daytime sleepiness, depression, and anxiety also improved. Gains were generally maintained over time. Preliminary evidence suggests that adolescent cognitive-behavioral sleep interventions are effective, but further high-quality RCTs are needed. Suggestions for further research are provided.

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Systematic Review and Meta-analysis of Adolescent Cognitive–Behavioral Sleep Interventions

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