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）：医学研究所将充足的睡眠确定为 2020 年健康人群的主要健康行为目标之一。随着青春期睡眠调节（睡眠）的变化，年龄较大（高中年龄段）的青少年特别容易睡眠不足。体内平衡和昼夜节律）越来越有利于晚上和夜间的警觉性，这使得提早入睡变得困难，而这些生物变化与高中早期的开学时间相吻合。因此，许多高中生（14-17 岁）面临着晚睡的生物驱动力和早起上学的社会驱动力的冲突。美国大约 80% 至 90% 的老年青少年表示，上学之夜的睡眠时间平均比建议的睡眠时间少 1 至 2 小时。睡眠限制与许多负面结果相关，包括情绪低落和自杀意念的风险增加、决策失误、学业成绩差和肥胖。该项目的总体目标是制定有效且可行的干预措施，以延长年龄较大青少年在学校晚上的睡眠时间。此应用程序是对 PA-11-063 的回应，该申请呼吁“……开发和完善新的健康相关行为干预措施，专门针对采用或维持健康行为。”我们建议开发和测试一种可行的行为干预措施，通过推进昼夜节律系统并为最有可能出现学校夜间睡眠不足风险的青少年（有以下情况的高中生）提供课后活动时间管理计划来增加学校夜间睡眠持续时间在学校晚上难以按时早点入睡。研究 1（干预措施开发）将检查两种不同持续时间（30 分钟和 90 分钟）的早晨强光与室内光（在一个周末在实验室进行测试）的有效性和可接受性。我们将根据实验室收集的青少年的新数据来计算强光的时间。我们将在研究 2 中使用研究 1 的结果（干预概念的证明），该研究利用实验室周末的早晨明亮的光线。周末起床时间（以及亮光的开始时间）和就寝时间将提前，以推进昼夜节律系统，从而在接下来的上学周中促进更早入睡。还将实施学校夜间时间管理计划，以方便早起就寝。昼夜节律阶段、睡眠、神经行为功能和情绪将在干预前和干预后立即进行测量，并与对照组进行比较，对照组保持平常的睡眠时间表，周末不来实验室进行强光治疗，也不接受任何强光治疗。课后时间管理指导。长期效果将在三周的维持期后进行检查，在此期间，青少年将被指导遵循较早和较长的睡眠时间表，并在周末早晨在家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受限的青少年提供基于证据的治疗策略，以及该年龄组对治疗的可接受性和依从性。