Targeted Sleep Enhancement Reduces Residual Anxiety Symptoms in Peri-Adolescents Previously Treated for Anxiety Disorders

Abstract

Sleep-related problems (SRPs) are a common precursor to anxiety disorders, especially during peri-adolescence, and may be a predictor of treatment response. However, evidence-based anxiety treatments do not alleviate SRPs to a clinically significant degree. The current study examines whether improving sleep in a sample of young adolescents previously treated for anxiety disorders can further reduce anxiety severity. Participants include 46 adolescents (65% female, ages 9-14 years) previously treated for anxiety disorders who self-selected to participate in a 6-week open trial of targeted sleep enhancement (TIGERS). Measures of parent and child-report on SRPs, and clinician rated anxiety severity, were collected at several timepoints of the study: pre-, and post-anxiety treatment, pre- and post-TIGERS, and at four yearly follow-ups. Two hierarchical mediation models were run using either parent or child report on sleep. On the between subjects level, participants with higher overall average SRPs also had higher overall anxiety severity over all timepoints. On the within subjects level, participation in TIGERS was not directly associated with change in anxiety severity, however, participation in TIGERS was associated with a drop in SRPs which was associated with a drop in anxiety severity. Improving sleep in anxious peri-adolescents further improves anxiety above and beyond anxiety treatment. Further research is needed confirm the effects of improving sleep on clinical anxiety in a randomized controlled trial.