Abstract

Objectives: The current study aimed to evaluate school-based motivational sleep education programs (SEPs) with adjunct bright light therapy (BLT) and/or parental involvement (PI).
Design: Randomized controlled trial.
Setting: Six high schools, matched on socio-economic status (SES).

Participants: A total of 193 adolescents (mean age, 16.3 ± 0.4 years, 79%f).
Intervention: 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.
Measurements: Online questionnaires measuring sleep knowledge, sleep patterns (bedtime, sleep latency, total sleep time [TST], etc) and mood at pre-intervention and post-intervention and 6-week follow-up. Intervention groups also completed a motivation-to-change questionnaire and provided qualitative feedback.

Results: 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 b .005).
Conclusions: This motivational SEP produced meaningful and similar benefits for adolescents in all inter- vention groups. Longer BLT (ie, over school holidays) and more intensive parental inclusion should be in- vestigated in future studies.