Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago IL, USA.
Sleep. 2023 Jan 11;46(1). doi: 10.1093/sleep/zsac202.
Shift sleep onset earlier and extend school-night sleep duration of adolescents.
Forty-six adolescents (14.5-17.9 years; 24 females) with habitual short sleep (≤7 h) and late bedtimes (≥23:00) on school nights slept as usual for 2 weeks (baseline). Then, there were three weekends and two sets of five weekdays in between. Circadian phase (Dim Light Melatonin Onset, DLMO) was measured in the laboratory on the first and third weekend. On weekdays, the "Intervention" group gradually advanced school-night bedtime (1 h earlier than baseline during week 1; 2 h earlier than baseline during week 2). Individualized evening time management plans ("Sleep RouTeen") were developed to facilitate earlier bedtimes. On the second weekend, Intervention participants received bright light (~6000 lux; 2.5 h) on both mornings. A control group completed the first and third weekend but not the second. They slept as usual and had no evening time management plan. Weekday sleep onset time and duration were derived from actigraphy.
Dim light melatonin onset (DLMO) advanced more in the Intervention (0.6 ± 0.8 h) compared to the Control (-0.1 ± 0.8 h) group. By week 2, the Intervention group fell asleep 1.5 ± 0.7 h earlier and sleep duration increased by 1.2 ± 0.7 h; sleep did not systematically change in the Control group.
This multi-pronged circadian-based intervention effectively increased school-night sleep duration for adolescents reporting chronic sleep restriction. Adolescents with early circadian phases may only need a time management plan, whereas those with later phases probably need both time management and morning bright light.
Teen School-Night Sleep Extension: An Intervention Targeting the Circadian System (#NCT04087603): https://clinicaltrials.gov/ct2/show/NCT04087603.
提前青少年的睡眠起始时间并延长上学日夜间的睡眠时间。
46 名青少年（14.5-17.9 岁；24 名女性）在上学日晚上习惯性地睡眠不足（≤7 小时）且晚睡（≥23:00），他们先按常规作息进行了两周（基线期）的睡眠。然后，中间有三个周末和两个五工作日。在第一个和第三个周末，在实验室中测量了昼夜节律相位（暗微光褪黑素起始时间，DLMO）。在工作日，“干预”组逐渐提前上学日晚上的睡眠时间（第 1 周比基线提前 1 小时；第 2 周比基线提前 2 小时）。为了促进更早的睡眠时间，制定了个性化的晚上时间管理计划（“Sleep RouTeen”）。在第二个周末，干预组的参与者在两个早上都接受了明亮的光线（~6000 勒克斯；2.5 小时）。对照组完成了第一个和第三个周末，但没有进行第二个周末的实验。他们按常规作息，没有晚上时间管理计划。通过活动记录仪得出工作日的入睡时间和持续时间。
干预组的暗微光褪黑素起始时间（DLMO）比对照组（-0.1±0.8 小时）提前了 0.6±0.8 小时。到第 2 周，干预组入睡时间提前了 1.5±0.7 小时，睡眠时间增加了 1.2±0.7 小时；而对照组的睡眠没有系统地改变。
这种多方面的基于昼夜节律的干预措施有效地增加了报告慢性睡眠限制的青少年的上学日夜间睡眠时间。昼夜节律相位较早的青少年可能只需要一个时间管理计划，而相位较晚的青少年可能既需要时间管理又需要早上的明亮光线。
青少年上学日睡眠延长：一项针对昼夜节律系统的干预措施（#NCT04087603）：https://clinicaltrials.gov/ct2/show/NCT04087603。
