Brief Interventions for Teen Sleep (BITS)

University Of Pittsburgh At Pittsburgh, Pittsburgh PA

Investigators

Linked publications, trials & patents

Abstract

Suicide is the second leading cause of death in youth, and recent statistics indicate disproportionate risk for suicidal behavior across demographic groups h. Unfortunately, few interventions effectively prevent youth suicidal thoughts and behaviors (STB). Experts emphasize that ideal foci for effective STB prevention interventions are proximal, robust and modifiable, with broad acceptability and accessibility for population-level impact. Sleep difficulties may be a particularly promising target for youth STB prevention efforts. Studies consistently demonstrate a direct and temporal link between sleep disturbances and STB in adolescents and are included among the expert consensus set of warning signs for suicide. Yet, no intervention targeting sleep difficulties has been examined among youth at-risk for STB nor tailored to youth across all demographic groups. We posit a modularized intervention that targets a range of sleep and circadian difficulties using evidence-based principles, such as the Transdiagnostic Sleep and Circadian Intervention (TSC), holds promise to decrease risk for STB in depressed adolescents. To optimize TranS-C+BL feasibility, acceptability, and scalability for youth at-risk for STB, among whom mental health services are more stigmatized, we will draw upon the expertise in implementation science and qualitative methods among our team. We will apply the Consolidated Framework for Implementation Research (CFIR) to conduct of qualitative interviews with youth, caregivers and providers to identify barriers and facilitators to TranS-C+BL implementation in primary care and employ the ADAPT-ITT framework during conduct of rapid iterative pilots to inform TrandS-C+BL implementation with depressed adolescents. We will then conduct a randomized trial with 75 youth (age 12-18) at-risk for STB (moderate-severe depression) and clinically significant sleep difficulties identified in primary care via the R01. Using 2:1 allocation (to maximize data on implementation), we will compare Sleep Feedback Alone (user-friendly graphs of naturalistic objective and subjective sleep data) vs the adapted TranS-C+BL + Sleep Feedback. Youth will complete objective ambulatory sleep assessment (actigraphy), , and subjective daily sleep diary (via smartphone) and receive weekly Sleep Feedback reports. TranS-C+BL clinicians will personalize TranS-C+BL strategies using youths’ Sleep Feedback data. We will examine TranS-C+BL implementation outcomes (feasibility, acceptability, appropriateness), impact on sleep disturbance (primary target; amount, regularity and timing of sleep), depression and STB risk (secondary outcomes) as assessed at 1, 3,6 and 12 months. Resultant data supporting TranS-C+BL will inform a larger randomized trial.