Bonnar Daniel, Gradisar Michael, Moseley Lynette, Coughlin Anne-Marie, Cain Neralie, Short Michelle A
Flinders University, School of Psychology, Adelaide, South Australia, Australia.
Flinders University, School of Psychology, Adelaide, South Australia, Australia.
Sleep Health. 2015 Mar;1(1):66-74. doi: 10.1016/j.sleh.2014.11.002. Epub 2014 Dec 9.
The current study aimed to evaluate school-based motivational sleep education programs (SEPs) with adjunct bright light therapy (BLT) and/or parental involvement (PI).
Randomized controlled trial.
Six high schools, matched on socio-economic status (SES).
A total of 193 adolescents (mean age, 16.3 ± 0.4 years, 79%f).
Classes were randomly assigned to (i) SEP + BLT, (ii) SEP + PI, (iii) SEP + BLT + PI, or (iv) classes-as-usual (CAU). Sleep education programs involved 4×50 minute classes (over 4 weeks) based on a Motivational Interviewing framework (Sleep Med 2011;12:246-251). Students in BLT groups attempted a weekend phase advance using portable green light LED glasses (500 nm; 506 lux). Parents of PI groups watched a series of 4 YouTube clips (2-3 minutes in length) outlining their adolescent's learning in class and how they could assist. Students in the CAU groups continued their regular classes.
Online questionnaires measuring sleep knowledge, sleep patterns (bedtime, sleep latency, total sleep time [TST], etc) and mood at preintervention and postintervention and 6-week follow-up. Intervention groups also completed a motivation-to-change questionnaire and provided qualitative feedback.
Improvements in sleep knowledge (d = 0.59-0.88), sleep onset latency (d = 0.45-0.50), TST (d = 0.32-0.57), and mood (d = 0.24-0.46) were observed in all intervention groups relative to the CAU group. Similar improvements were observed in a subgroup of students identified as having delayed sleep timing (ie, sleep knowledge: d = 0.45-0.92; sleep onset latency: d = 0.59-0.82; TST: d = 0.82-1.18). Increases in motivation to regularize out of bedtimes, obtain morning bright light (BLT groups), and avoid sleeping-in on weekends occurred (all P < .005).
This motivational SEP produced meaningful and similar benefits for adolescents in all intervention groups. Longer BLT (ie, over school holidays) and more intensive parental inclusion should be investigated in future studies.
本研究旨在评估以学校为基础的动机性睡眠教育项目（SEP），并辅以强光疗法（BLT）和/或家长参与（PI）。
随机对照试验。
六所社会经济地位（SES）相匹配的高中。
共193名青少年（平均年龄16.3±0.4岁，79%为女性）。
班级被随机分配到（i）SEP+BLT，（ii）SEP+PI，（iii）SEP+BLT+PI，或（iv）常规课程（CAU）。睡眠教育项目包括基于动机性访谈框架的4节50分钟课程（为期4周）（《睡眠医学》2011年；12:246 - 251）。BLT组的学生使用便携式绿灯LED眼镜（500纳米；506勒克斯）尝试在周末提前入睡阶段。PI组的家长观看了一系列4个YouTube视频片段（时长2 - 3分钟），内容概述了他们青少年在课堂上的学习情况以及他们如何提供帮助。CAU组的学生继续他们的常规课程。
在干预前、干预后和6周随访时，通过在线问卷测量睡眠知识、睡眠模式（就寝时间、入睡潜伏期、总睡眠时间[TST]等）和情绪。干预组还完成了一份改变动机问卷并提供了定性反馈。
与CAU组相比，所有干预组在睡眠知识（d = 0.59 - 0.88）、入睡潜伏期（d = 0.45 - 0.50）、TST（d = 0.32 - 0.57）和情绪（d = 0.24 - 0.46）方面均有改善。在被确定为睡眠时相延迟的学生亚组中也观察到了类似的改善（即睡眠知识：d = 0.45 - 0.92；入睡潜伏期：d = 0.59 - 0.82；TST：d = 0.82 - 1.18）。出现了调整就寝时间、获取早晨强光（BLT组）和避免周末睡懒觉的动机增加（所有P < .005）。
这种动机性SEP对所有干预组的青少年都产生了有意义且相似的益处。未来的研究应调查更长时间的BLT（即在学校假期期间）和更深入的家长参与情况。
