Teen School-Night Sleep Extension: An Intervention Targeting the Circadian System

青少年学校晚上的睡眠延长：针对昼夜节律系统的干预措施

• 批准号: 8919441
• 负责人: Stephanie Crowley McWilliam
• 金额: $ 59.39万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8919441
• 关键词: Adherence; Adolescent; Adoption; Alcohol consumption; Anxiety; Behavior; Behavior Therapy; Biological; Boxing; Child; Circadian Rhythms; Conflict (Psychology); Control Groups; Cues; Data; Decision Making; Depressed mood; Development; Disease; Drug usage; Effectiveness; Effectiveness of Interventions; Evidence based treatment; Feeling suicidal; Health; Health behavior; Healthy People 2020; High School Student; Home environment; Homeostasis; Human; Institute of Medicine (U.S.); Instruction; Intervention; Learning; Life; Light; Maintenance; Mammals; Measures; Melatonin; Moods; Obesity; Outcome; Outcome Measure; Overweight; Participant; Performance; Personal Satisfaction; Phase; Phototherapy; Problem Solving; Psychosocial Factor; Puberty; Reporting; Research Project Grants; Risk; Risk Behaviors; Risk-Taking; Schedule; School-Age Population; Schools; Sleep; Sleep Disorders; Stimulus; System; Teenagers; Testing; Time; Time Management; age group; aged; alertness; automobile accident; base; cognitive process; emotion regulation; executive function; experience; falls; follow-up; high school; improved; neurobehavioral; novel; processing speed; response; sleep onset; sleep regulation; social; therapy development; treatment strategy

DESCRIPTION (provided by applicant): The Institute of Medicine identified sufficient sleep as one of the leading health behavior objectives for Healthy People 2020. Older (high-school-aged) adolescents are especially vulnerable to insufficient sleep as pubertal changes to sleep regulation (sleep homeostasis and circadian timing) increasingly favor alertness later into the evening and night, making an early sleep onset difficult, and these biological changes coincide with early high school start times. Thus, many high schoolers (aged 14-17 years) are faced with a conflicting biological drive to fall asleep late and a social drive to wake early for school. Approximately 80 to 90% of older adolescents in the U.S. report an average of 1 to 2 h less sleep than recommended on school nights. Sleep restriction is associated with many negative outcomes, including an increased risk for depressed mood and suicidal ideation, poor decision making, poor academic grades, and obesity. The broad objective of this project is to develop an effective, yet feasible intervention to extend school-night sleep duration of older adolescents. This application is in response to PA-11-063, which calls for "...developing and refining novel health-related behavioral interventions specifically targeting adoption or maintenance of health behavior." We propose to develop and test a feasible behavioral intervention to increase school-night sleep duration by advancing the circadian system and providing a time management plan for after-school activities in youngsters most at risk for insufficient school-night sleep - high school students who experience difficulties falling asleep at a desired early time on school nights. Study 1 (intervention development) will examine effectiveness and acceptability of two different durations (30 mins & 90 mins) of morning advancing bright light compared to room light (tested in the lab on one weekend). We will time the bright light based on new data from adolescents collected in our lab. We will use the results of Study 1 in Study 2 (proof of intervention concept), which utilizes morning bright light on one weekend spent in the lab. Weekend wake time - and the start of bright light - and bedtime will shift earlier to advance the circadian system to facilitate earlier sleep onset during the subsequent school week. A school-night time management plan will also be implemented to facilitate these earlier bedtimes. Circadian phase, sleep, neurobehavioral functioning and mood will be measured before and immediately after the intervention and compared to a control group who keeps their usual sleep schedules at home, does not come to the lab for weekend bright light treatment, and is not given any after-school time-management instruction. Long-term effectiveness will be examined after a 3-week maintenance period, during which adolescent will be instructed to follow their earlier and longer sleep schedule and use occasional bright light on weekend mornings at home. Adherence and acceptability of the intervention will be assessed. These data will provide evidence-based treatment strategies for delayed and sleep-restricted adolescents, and acceptability of and adherence to the treatment in this age group.

描述（由申请人提供）：医学研究所确定了足够的睡眠是2020年健康人的主要健康行为目标之一。年龄较大（高中生时代的）青少年特别容易受到足够的睡眠，因为睡眠调节的青春期变化（睡眠整体稳定和昼夜节律的时间）越来越多地在晚上和晚上越来越多地进行了早期的良性，使得早期的工作变得越来越困难。因此，许多高中生（14-17岁）面临着相互冲突的生物学动力，迟到了入睡，并有社交动力，以提早上学。美国大约80％至90％的年长青少年报告说，平均比上学之夜建议的睡眠少1至2 h。睡眠限制与许多负面结果有关，包括情绪低落和自杀意念的风险增加，决策不力，学术成绩不佳和肥胖。该项目的广泛目的是开发一种有效但可行的干预措施，以延长年长的青少年的学位睡眠时间。该应用是对PA-11-063的响应，该申请要求“……开发和完善与健康相关的新型行为干预措施，专门针对采用或维持健康行为”。我们建议开发和测试可行的行为干预措施，以通过推进昼夜节律系统并为年轻人的课后活动提供时间管理计划，以增加学校晚上的睡眠时间，以期在学校晚上睡眠不足的年轻人风险 - 高中生 - 高中生，他们在上学晚上在所需的早期睡觉而遇到困难的高中生。研究1（干预开发）将检查与房间光相比（一个周末在实验室中测试），早晨有两个不同持续时间（30分钟和90分钟）的有效性和可接受性。我们将根据来自实验室收集的青少年的新数据来计时明亮的光。我们将在研究2中使用研究1的结果（干预概念证明），该研究利用在实验室度过的一个周末的早晨亮光。周末唤醒时间 - 明亮的灯光开始 - 就寝时间将更早地转移，以推动昼夜节律系统，以促进随后的上学期间的早期睡眠。还将实施一项校晚期的管理计划，以促进这些早期的床位。昼夜节律阶段，睡眠，神经行为的功能和情绪将在干预前后立即进行测量，并与对照组保持在家中通常的睡眠时间表的对照组，并未来实验室进行周末光明的轻度治疗，并且没有获得任何课后时间管理指导。长期的效率将在经过3周的维护期之后进行检查，在此期间，将指示青少年遵循他们的早期睡眠时间表，并在家中周末早晨偶尔使用明亮的光线。将评估干预措施的依从性和可接受性。这些数据将为延迟和睡眠限制的青少年提供基于证据的治疗策略，以及该年龄段的治疗的可接受性和依从性。