091 The Feasibility of At-home Sleep Extension in Adolescents and Young adults: A Meta-Analysis and Systematic Review

Abstract

Abstract Introduction Insufficient sleep duration has negative consequences for health and performance and is alarmingly common in adolescents and young adults. The primary aim of the meta-analysis and systematic review was to assess whether at-home sleep extension is a feasible means to improve sleep duration and daytime sleepiness without negative consequences for sleep quality or efficiency in adolescents and young adults. An additional aim of the review was to provide a qualitative summary of the health and performance outcomes associated with at-home sleep extension. Methods Peer-reviewed journal articles and doctoral dissertations available in English were searched and screened. Eligible studies had at least five consecutive days of at-home sleep extension, measurement of sleep duration during baseline/habitual sleep and extension of sleep opportunity, and participants 13–30 years of age. Information on primary sleep outcome (i.e., sleep duration), available secondary sleep outcomes (i.e., sleep opportunity, sleep efficiency, sleep quality, daytime sleepiness), and health and performance outcomes were extracted for quantitative synthesis and qualitative review. Results Of the 2254 articles assessed for eligibility, 17 studies (seven in adolescents and ten in young adults) met the eligibility criteria for this review. The average number of days of sleep manipulation was 14.29 (range: 5 to 49 nights). At-home extension of sleep opportunity reliably increased objective (ES = 0.97) and subjective sleep duration (ES = 2.19) and sleep quality (ES = 0.24), and decreased daytime sleepiness (ES = -0.39), when compared to unmanipulated sleep opportunity. Sleep extension was also found to have additional health (e.g., lower psychological stress) and performance benefits (e.g., better athletic performance) across ages and populations. A potential upward publication bias was found based on the distribution of within-subject effect sizes of actigraphic sleep duration. Conclusion The review indicates that at-home sleep extension is feasible in adolescents and young adults to improve sleep duration and daytime sleepiness, and maintain or improve sleep quality. However, the degree of improvement in sleep duration, sleep quality, and daytime sleepiness varied by study population and sleep extension method. Future research should investigate how variations in population and methods of sleep extension impact health and performance outcomes. Support (if any):