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Sleep IntervEntion as Symptom Treatment for ADHD

Not Applicable
Completed
Conditions
CBT
Adolescents
ADHD
Sleep
Interventions
Behavioral: SIESTA
Other: Treatment as usual for ADHD
Registration Number
NCT04723719
Lead Sponsor
Universitaire Ziekenhuizen KU Leuven
Brief Summary

Up to 72% of adolescents with ADHD portray sleep problems. The most common sleep difficulties in adolescents with ADHD are initial insomnia, nocturnal awakenings, non-restorative or restless sleep. These difficulties seem to be causally related to increased ADHD symptom impairment, oppositional and depressive symptomatology, and functional impairments in daily life, resulting in a vicious circle of sleep problems and impairment. Thus, reducing sleep problems is an important intervention target. However, to date there is no evidence-based cognitive behavioral sleep treatment available. Sleep-focused treatments need adaptation towards this developmental phase/disorder for effectiveness, as ADHD and sleep problems are bi-directional. Therefore, a blended treatment targeting the core deficits integrating motivational interviewing, planning skills and sleep interventions is needed. Thus, the aim of this project is testing the short and 3 months follow-up effectiveness of the blended CBT sleep intervention in adolescents with ADHD.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
92
Inclusion Criteria
  1. Attending secondary education and between 13-17 years old

  2. prior diagnosis of ADHD (any presentation) and confirmation of DSM-5 criteria of ADHD in current study

  3. Displaying sleep problems for at least 3 nights per week for at least 3 months

    1. sleep onset latency of at least 20-30 minutes
    2. and/or wake after sleep onset greater than 30 min
    3. and/or an average sleep time of less than 7 hours
    4. and at least one poor sleep hygiene practice
    5. and experienced distress as indicated by parent/guardian and/or adolescent.
  4. estimated IQ≥80

  5. stable ADHD medication use at least 4 weeks before start of treatment and no dose or medication type changes planned during active treatment

Exclusion Criteria
  1. the following comorbidities: sleep-breathing disorder, restless leg syndrome, narcolepsy, conduct disorder, depressive disorder with suicide risk or active suicidality, autism spectrum disorder, or substance use disorder, with an exception for nicotine
  2. acute crisis situation at home
  3. physical problems that interfere with sleep (e.g. pain) or medical disorders and related medication that could affect sleep
  4. participation in a behaviorally based sleep intervention in the 6 months prior to our study
  5. currently taking pharmacological medication for sleep (including melatonin), anxiety or depression. Participation will be allowed after a two-week wash-out period of the medication

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
SIESTA training + treatment as usual for ADHDSIESTAWe developed a cognitive behavioral therapy for sleep problems in adolescents with ADHD. This includes seven individual sessions with the adolescent and two individual sessions with the parent(s)/guardian(s). Participants receive this CBT training called SIESTA next to their treatment as usual for ADHD symptomatology (mostly ADHD-medication).
Treatment as usual for ADHD onlyTreatment as usual for ADHDParticipants continue their treatment as usual for ADHD (mostly ADHD-medication).
SIESTA training + treatment as usual for ADHDTreatment as usual for ADHDWe developed a cognitive behavioral therapy for sleep problems in adolescents with ADHD. This includes seven individual sessions with the adolescent and two individual sessions with the parent(s)/guardian(s). Participants receive this CBT training called SIESTA next to their treatment as usual for ADHD symptomatology (mostly ADHD-medication).
Primary Outcome Measures
NameTimeMethod
Sleep problems CSRQ pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

subjective sleep problems assessed by questionnaires (CSRQ)

Sleep problems CSHQ pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

subjective sleep problems assessed by questionnaires (CSHQ)

Sleep architecture objective TST pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

objective (actigraphy) sleep architecture (specified as TST in hours and minutes)

Sleep architecture objective SE pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

objective (actigraphy) sleep architecture (specified as SE = TST/time in bed in percentage)

Sleep architecture objective NoA pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

objective (actigraphy) sleep architecture (specified as NoA)

Sleep architecture subjective TST pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

subjective (sleep logs) sleep architecture (specified as TST in hours and minutes)

Sleep problems SSHS pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

subjective sleep problems assessed by questionnaires (SSHS)

Sleep architecture objective SOL pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

objective (actigraphy) sleep architecture (specified as SOL in hours and minutes)

Sleep architecture subjective SOL pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

subjective (sleep logs) sleep architecture (specified as SOL in hours and minutes)

Sleep architecture subjective SE pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

subjective (sleep logs) sleep architecture (specified as SE = TST/time in bed in percentage)

Sleep architecture objective SOL pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

objective (actigraphy) sleep architecture (specified as SOL in hours and minutes)

Sleep architecture subjective TST pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

subjective (sleep logs) sleep architecture (specified as TST in hours and minutes)

Sleep architecture objective TST pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

objective (actigraphy) sleep architecture (specified as TST in hours and minutes)

Sleep architecture subjective SE pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

subjective (sleep logs) sleep architecture (specified as SE = TST/time in bed in percentage)

Sleep architecture subjective NoA pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

subjective (sleep logs) sleep architecture (specified as NoA)

Sleep problems SSHS pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

subjective sleep problems assessed by questionnaires (SSHS)

Sleep hygiene pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

subjective sleep hygiene assessed by questionnaires (ASHSr)

Sleep hygiene pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

subjective sleep hygiene assessed by questionnaires (ASHSr)

Sleep architecture subjective NoA pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

subjective (sleep logs) sleep architecture (specified as NoA)

Sleep architecture objective SE pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

objective (actigraphy) sleep architecture (specified as SE = TST/time in bed in percentage)

Sleep architecture objective NoA pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

objective (actigraphy) sleep architecture (specified as NoA)

Sleep architecture subjective SOL pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

subjective (sleep logs) sleep architecture (specified as SOL in hours and minutes)

Sleep problems CSRQ pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

subjective sleep problems assessed by questionnaires (CSRQ)

Sleep problems CSHQ pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

subjective sleep problems assessed by questionnaires (CSHQ)

Secondary Outcome Measures
NameTimeMethod
Comorbidities: anxiety pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

Assessed by adolescent (SCARED-R)

Comorbidities: anxiety pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

Assessed by adolescent (SCARED-R)

ADHD symptoms pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

Assessed by parents (DBDRS)

Academic competence pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

Assessed by teacher (CPS)

Comorbidities: oppositional-defiant disorder pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

Assessed by parents (DBDRS)

Comorbidities: oppositional-defiant disorder pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

Assessed by parents (DBDRS)

Parent-adolescent conflict pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

Assessed by parents (CBQ)

Parent-adolescent conflict pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

Assessed by parents (CBQ)

Homework problems pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

Assessed by parents (HPC)

Academic competence pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

Assessed by teacher (CPS)

Homework problems pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

Assessed by parents (HPC)

Comorbidities: depression pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

Assessed by adolescent (CDI-2)

Comorbidities: depression pre-test to follow-upFrom pre-test to follow-up (+-3 months after posttest)

Assessed by adolescent (CDI-2)

ADHD symptoms pre-test to post-testFrom pre-test to post-test (+- 8 weeks)

Assessed by parents (DBDRS)

Trial Locations

Locations (1)

UPC Leuven

🇧🇪

Leuven, Vlaams Brabant, Belgium

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