Effectiveness of a cognitive-behavioral sleep hygiene intervention for adolescents with ADHD: a randomized controlled trial.

OBJECTIVE

Sleep problems are frequent and impairing in adolescents with ADHD. This randomized controlled trial investigates the effectiveness of a newly developed CBT sleep hygiene intervention for adolescents with ADHD - SIESTA.

METHOD

Adolescents with ADHD and sleep problems (N = 92, M = 14.36, SD = 1.43, 47% males) were randomized to receive SIESTA next to treatment as usual targeting ADHD (SIESTA+TAU) or TAU only. Adolescent and parent ratings, actigraphy and sleep diaries, were collected at pre-, post-, and at 4 month follow-up test. A linear mixed effects model was used with an intent-to-treat approach.

RESULTS

Results indicated significant improvement in SIESTA+TAU compared to TAU from pre- to post-test on sleep hygiene (effect size =.21), chronic sleep reduction (effect size =.15), and sleep-wake problem behaviors (effect size =.05). Actigraphy and sleep diaries showed no significant differences, with both groups improving on sleep diaries. The improvements in sleep hygiene were maintained at follow-up (effect size =.09). Of secondary outcomes, depressive symptoms reduced significantly more from pre- to post-test in SIESTA+TAU than in TAU only (effect size =.09).

CONCLUSIONS

This study indicates that SIESTA is effective at improving sleep hygiene, perceived sleep problems, and depressive symptoms in adolescents with ADHD. However, to maintain long-term effects, booster sessions may be beneficial.