Transdiagnostic Sleep and Circadian Intervention + Bright Light in Adolescents With Elevated Depression

Not Applicable

Not yet recruiting

• Conditions: Sleep Disturbance; Depression; Sleep; Suicide

• Registration Number: NCT06963463
• Lead Sponsor: University of Pittsburgh

Brief Summary

Suicide is the second leading cause of death in youth, and recent statistics indicate disproportionate risk for suicidal behavior among Black youth. Despite this, few interventions effectively prevent youth suicidal thoughts and behaviors (STB). Sleep difficulties may be a particularly promising target for youth STB prevention efforts. To date, no intervention targeting sleep difficulties have been examined among youth at-risk for STBs nor tailored to Black youth; this research is critical for maximizing intervention acceptability and impact.

The Transdiagnostic Sleep and Circadian Intervention (TranS-C) is an evidence-based, modularized intervention that targets a range of sleep and circadian difficulties, making it especially well-suited for treating adolescent sleep. Delivery of this intervention will be through telehealth with a Sleep Therapist. Youth will wear an actigraphy watch that monitors sleep and will complete daily sleep diaries via smartphone or email; sleep feedback reports of sleep diary and actigraphy data are available on demand after completing a diary entry. The adolescents will also wear bright light glasses in the morning and blue light blocking glasses in the evening. Adolescents will also attend weekly or biweekly sessions with a Sleep Therapist. The Sleep Therapist will review sleep feedback generated from actigraph and sleep diary data with adolescents during sessions.

In the Sleep Feedback alone intervention, adolescents will wear an actigraphy watch and complete daily diaries; they are able to view their sleep feedback on demand through user-friendly graphs of naturalistic objective and subjective sleep data.

Detailed Description

The Study proposes to adapt TranS-C for at-risk adolescents using health equity-informed implementation science methods.

In this randomized trial we will enroll 75 youth aged 12-18 at risk for STB and clinically significant sleep difficulties identified in primary care. The randomization that this study uses is a 2:1 allocation to compare TranS-C+Sleep Feedback vs. Sleep Feedback Alone.

Study Timeline

• Status Verified: 2025-05
• Study First Submitted: 2025-05-06
• Study First Submitted QC: 2025-05-06
• Last Update Submitted: 2025-05-06
• Study First Posted: 2025-05-09
• Last Update Posted: 2025-05-09
• Study Start: 2025-05-30
• Primary Completion: 2026-12-31
• Study Completion: 2027-07-31

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 90

Inclusion Criteria

• Adolescents (12-18)
• Current moderate to severe depression as measured by the PHQ-9M with a total score of greater than or equal to 11
• Current clinically significant sleep disturbance measured by the PHQ-9-M sleep item greater than or equal to 2.
• English language fluency and literacy sufficient to engage in study protocol.

Exclusion Criteria

• Evidence of obstructive sleep apnea,
• Evidence of restless legs syndrome
• Evidence of psychosis
• Evidence of bipolar disorder
• Evidence of a developmental disability precluding comprehension of study procedures per electronic health record and eligibility screening.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Feasibility-Attendance	From enrollment to the end of the treatment (up to 4 months)	Feasibility of interventions as by measured by the mean of number of sessions attended. Local study documents are used to track each session that was completed.
Feasibility-Attrition	From enrollment until withdrawal or completing treatment sessions.	Attrition will be assessed using a study-specific form reflecting participants who withdraw or are withdrawn from the TranS-C+ intervention. The proportion of patients who withdraw or are withdrawn will be calculated.
Acceptability-Treatment Satisfaction	4 month	Treatment satisfaction will be measured by the patient-reported Treatment Satisfaction Questionnaire administered post-treatment. The Treatment Satisfaction Questionnaire assesses satisfaction with the treatment received and perception of progress; each item is rated on a Likert scale. Additional open-ended questions allow for participants to share feedback on strengths and weaknesses as well as any other feedback related to their satisfaction with the intervention. The Questionnaire has questions on a 1(Not at all)-7(Very Much). Questions on study clinicians are asked on a 1(Poor)-7(Superior) Likert scale. Questions on the duration of study on a 1(Much too short)-7(Much to long) Likert scale. Questions about frequency of visits on a 1(Much too infrequent)-7(Much to frequent). Questions for recommendations to other rated on a 1(Strongly recommend)-7(Strongly not recommend). Questions on future outlook rated on a 1(Very Pessimistic)-7(Very Optimistic).

Secondary Outcome Measures

Name	Time	Method
Sleep Disturbance	4 months	Self-reported sleep disturbance will be assessed via the Pediatric PROMIS Sleep Disturbance and Sleep Related Impairment Measures. The Patient-Reported Outcomes Measurement Information System is an 8-item measure. The scoring ranges from Never (1) Almost Never (2) Sometimes (3) Almost Always (4) Always (5). The PROMIS scale is scored on the T-score metric scale. The higher the participant scores more of the concept being measured. With the general population getting a score of 50 with a standard deviation of 10
Depression	4 month	Depressive symptom severity will be assessed via the self-reported PHQ-9-M. The Patient Health Questionnaire is a 13-item measure. The questions are rating on a 0(Not at all)- 3(Nearly Every day) Likert scale. Additional questions rated on a scale of Not difficult at all to Extremely difficult, along with yes/no questions. The PHQ-9M is rated on a scale from 0 to 27. Higher scores are associated with higher levels of, or more severe, depression
Risk for Suicidal Thoughts and Behaviors	4 month	Suicidal thoughts and behaviors will be assessed via the C-SSRS. The Columbia-Suicide Severity Rating Scale is an 18-item measure. This measure contains yes/no questions, asking about both about suicidality over the past 3 months and lifetime. In the C-SSRS the higher the score the more risk of suicidality (0 = No risk reported (all "no" responses),1 - 2 = Low risk ,3 - 6 = Moderate to high risk)

Trial Locations

Locations (2)

Childrens Hospital of Philadelphia; 🇺🇸 Philadelphia, Pennsylvania, United States

University of Pittsburgh; 🇺🇸 Pittsburgh, Pennsylvania, United States