Investigating the Feasibility, Acceptability, and Preliminary Effectiveness of a Sleep Intervention for Adolescents With Co-morbid Insomnia and Mental Health Difficulties
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Insomnia
- Sponsor
- Stephanie McCrory
- Enrollment
- 16
- Locations
- 1
- Primary Endpoint
- Number of Adolescent Participants Recruited
- Status
- Terminated
- Last Updated
- 7 months ago
Overview
Brief Summary
The overall objectives of the study are to:
- To assess the feasibility of delivering the Strathclyde Sleep Intervention to adolescents with co-morbid insomnia and mental health attending a mental health services The following feasibility benchmarks will be assessed: recruitment and retention, participant attendance, staff training, intervention fidelity and participant adherence.
- To examine participant acceptability. The researchers will conduct qualitative interviews with the participants and delivery staff to examine the acceptability of the programme.
- To investigate the preliminary effectiveness by assessing the following: sleep parameters, insomnia symptoms, Circadian phase preference (baseline only) and mental health symptoms. Data will be collected at baseline, post-intervention and 3 month follow-up.
Detailed Description
Sleep problems have a significant detrimental impact on physical health, development, and functioning and are commonly experienced co-morbidly with other mental health problems. Therefore, many adolescents who are attending mental health services, also experience significant sleep disturbances. However, sleep problems are rarely addressed within mental health services due to lack of awareness of the importance of sleep and/or training in effective treatments. Cognitive behavioural therapy for insomnia (CBT-I) is the recommended approach for treating insomnia in both adult and adolescent populations. Despite this, there has been limited research investigating the delivery of CBT-I interventions to adolescents with co-morbid mental health problems, and to our knowledge, no such studies exist within the Scottish context. The Strathclyde Sleep Intervention incorporates CBT-I components to improve adolescent sleep. This study aims to evaluate the feasibility, acceptability, and preliminary effectiveness of the intervention for adolescents attending mental health services. Staff within the service will receive training to deliver the Strathclyde Sleep Intervention to adolescents with co-morbid mental health and sleep problems. The following feasibility benchmarks will be assessed: recruitment and retention, participant attendance, facilitator training, intervention fidelity and participant adherence. Acceptability will be measured via qualitative interviews with participants and staff. Baseline, post-intervention, and follow-up assessments will be conducted to assess preliminary effectiveness of the intervention for improving sleep and mental health. This research is necessary to inform future trials of the Strathclyde Sleep Intervention and to support its wider implementation within services.
Investigators
Stephanie McCrory
Principal Investigator
University of Strathclyde
Eligibility Criteria
Inclusion Criteria
- •Adolescents (12-15 years)
- •Meeting thresholds for insomnia disorder (determined by cut-off scores on the 2 item Sleep Condition Indicator (score \<2 indicates probable insomnia)
- •Attending CAMHS for mental health intervention/support
- •Able to engage with intervention protocol
Exclusion Criteria
- •Active suicide ideation and/or recent suicidal attempts
- •Contraindicators for components of CBT-I (sleep restriction therapy) including seizure disorders/conditions including epilepsy, bipolar disorder, symptoms of psychosis, obstructive sleep apnea and parasomnias.
- •Diagnosis of Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder, Foetal Alcohol Spectrum Disorder (Neurodiversity)
- •Those who are currently completing, or have recently completed (in the past 6 months), CBT-I for insomnia elsewhere (or components of CBT-I including e.g. sleep restriction therapy, stimulus control, cognitive techniques). This will only include in-person, one-to-one methods of delivery
Outcomes
Primary Outcomes
Number of Adolescent Participants Recruited
Time Frame: 1 year
A total of 8 adolescents were referred between October 2023 and October 2024. Of these, 1 was ineligible, 4 declined participation / did not respond, and 3 provided consent and were enrolled.
Number of Adolescent Participants Who Attend Each Session
Time Frame: Over 4 session intervention period (1 - 4 months) 1-4 months 1-4 months
Measured through attendance logs. This outcome reports the number of adolescent participants who completed each session of the 4-session intervention.
Intervention Fidelity
Time Frame: 1-4 months
Fidelity was assessed using an intervention delivery checklist. Practitioners were categorised based on whether they delivered the intervention as intended or deviated. Of the 10 practitioners who completed training, only 3 practitioners delivered the intervention, but only 2 submitted fidelity data for this outcome.
Secondary Outcomes
- Acceptability of Intervention to Practitioners(Up to 9 months post-training)
- Sleep Outcomes (Change From Baseline, Post-intervention and Follow-up)(Baseline (2 weeks before intervention delivery))
- Insomnia Symptoms Assessed Using Sleep Condition Indicator (Score of <16 Indicates Probable Insomnia, Higher Scores Indicate Better Sleep, Scores Range 0-32) (Change From Baseline, Post-intervention and Follow-up)(Baseline (2 weeks before intervention) Baseline (2 weeks before intervention) Baseline (2 weeks before intervention))
- Depression and Anxiety Symptoms Assessed by Revised Child Anxiety and Depression Scale - 25 Item Version (RCADS-25) (Change From Baseline, Post-intervention and Follow-up)(Baseline (2-weeks before intervention delivery))
- Anxiety Symptoms Measured by GAD-7 (Change From Baseline, Post-intervention and Follow-up)(Baseline (2-weeks before intervention delivery))
- Depression Symptoms Measured by PHQ-9 (Change From Baseline, Post-intervention and Follow-up)(Baseline (2-weeks before intervention delivery))
- Circadian Phase Preference Measured by Morningness/Eveningness Scale for Children(Baseline only)