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Clin Child Fam Psychol Rev. 2017 Sep;20(3):227-249. doi: 10.1007/s10567-017-0234-5.

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

Author information

1
Melbourne School of Psychological Sciences, The University of Melbourne, 12th Floor Redmond Barry Building, Parkville Campus, Melbourne, VIC, 3010, Australia.
2
Oregon Research Institute, 1776 Millrace Dr, Eugene, OR, 97403, USA.
3
School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia.
4
Center for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Road, Parkville, VIC, 3052, Australia.
5
Melbourne School of Psychological Sciences, The University of Melbourne, 12th Floor Redmond Barry Building, Parkville Campus, Melbourne, VIC, 3010, Australia. nallen3@uoregon.edu.
6
Department of Psychology, University of Oregon, Eugene, OR, 97403-1227, USA. nallen3@uoregon.edu.

Abstract

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.

KEYWORDS:

Adolescence; Anxiety; Cognitive–behavioral therapy; Delayed sleep phase disorder; Depression; Insomnia; Intervention; Meta-analysis; Mindfulness; Sleep; Systematic review

PMID:
28331991
DOI:
10.1007/s10567-017-0234-5
[Indexed for MEDLINE]

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