Modifying the Impact of Eveningness Chronotype (“Night-Owls”) in Youth: A Randomized Controlled Trial

• Main Authors: Blum, D.J (Author), Dolsen, M.R (Author), Dong, L. (Author), Gumport, N.B (Author), Harvey, A.G (Author), Hein, K. (Author), Hinshaw, S.P (Author), Kanady, J. (Author), Rabe-Hesketh, S. (Author), Silk, J.S (Author), Smith, R.L (Author), Thompson, M.A (Author), Wyatt, J.K (Author), Zannone, N. (Author)
• Format: Article
• Language: English
• Published: Elsevier Inc. 2018
• Subjects: adolescent; Adolescent; adult; Article; child; Child; circadian; circadian rhythm; Circadian Rhythm; clinical outcome; controlled study; daytime somnolence; eveningness; female; Female; health status; Health Status; human; Humans; major clinical study; male; Male; physiology; prevention and control; priority journal; psychoeducation; randomized controlled trial; risk; self report; Self Report; sleep; Sleep; sleep deprivation; Sleep Deprivation; sleep therapy; sleep time; sleep waking cycle; time factor; Time Factors; transdiagnostic sleep and circadian intervention for youth; treatment
• Online Access: View Fulltext in Publisher

 Objective: To determine whether an intervention to reduce eveningness chronotype improves sleep, circadian, and health (emotional, cognitive, behavioral, social, physical) outcomes. Method: Youth aged 10 to 18 years with an evening chronotype and who were “at risk” in 1 of 5 health domains were randomized to: (a) Transdiagnostic Sleep and Circadian Intervention for Youth (TranS-C; n = 89) or (b) Psychoeducation (PE; n = 87) at a university-based clinic. Treatments were 6 individual, weekly 50-minute sessions during the school year. TranS-C addresses sleep and circadian problems experienced by youth by integrating evidence-based treatments derived from basic research. PE provides education on the interrelationship between sleep, stress, diet, and health. Results: Relative to PE, TranS-C was not associated with greater pre−post change for total sleep time (TST) or bed time (BT) on weeknights but was associated with greater reduction in evening circadian preference (pre−post increase of 3.89 points, 95% CI = 2.94−4.85, for TranS-C, and 2.01 points, 95% CI = 1.05−2.97 for PE, p = 0.006), earlier endogenous circadian phase, less weeknight−weekend discrepancy in TST and wakeup time, less daytime sleepiness, and better self-reported sleep via youth and parent report. In terms of functioning in the five health domains, relative to PE, TranS-C was not associated with greater pre−post change on the primary outcome. However, there were significant interactions favoring TranS-C on the Parent-Reported Composite Risk Scores for cognitive health. Conclusion: For at-risk youth, the evidence supports the use of TranS-C over PE for improving sleep and circadian functioning, and improving health on selected outcomes. Clinical trial registration information: Triple Vulnerability? Circadian Tendency, Sleep Deprivation and Adolescence. https://clinicaltrials.gov; NCT01828320. © 2018 American Academy of Child and Adolescent Psychiatry