A brief behavioral treatment for unresolved insomnia in adolescents: a single-case multiple baseline pilot study, evaluating self-reported outcomes of efficacy, safety, and acceptability.

Abstract

Insomnia is a significant problem for many adolescents and often is associated with detrimental effects on physical and mental health. Drawing on emerging models of intervention in the adult literature, this pilot study investigated the efficacy, safety, and acceptability of a novel, brief (3-week) behavioral intervention among adolescents with unresolved chronic insomnia. A multiple baseline (staggered start) A-B with follow-up single-case design (n = 2) was used to evaluate intervention outcomes across treatment and at 2-month follow-up in the domains of sleep, mood and affect, fatigue, and parent-child conflict. Outcomes were indexed with multi-informant data collected using adolescent reports on mood/affect and sleep diaries, and parent reports on parent-child conflict. Posttreatment and 2-month follow-up data indicated improvements in self-reported sleep quality, including sleep onset latency and increased sleep efficiency. Indicators related to participant mood, stress, and parent-child interactions remained relatively stable over the course of treatment, suggesting that the sleep restriction component of the intervention did not produce adverse effects for the adolescents or their families. A brief 3-week intervention adapted from the adult literature was associated with improved sleep-wake cycles in adolescents with chronic insomnia. Change during the treatment phase was particularly rapid and maintained over time. In conjunction with low observed risk and adverse effects, the potential for this treatment to provide a safe, acceptable, and cost-effective manualized treatment for adolescent insomnia warrants larger-scale clinical evaluation. Registry: Australian New Zealand Clinical Trials Registry; Title: Does a one month brief behavioral treatment improve sleep for high school adolescents (ages 12-17): an open label pilot study; Identifier: ACTRN12618000835246; URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375102.