Project SCIMA: A Sleep and Circadian intervention for Mental Health in Athletes

Our study will involve athletes who will all be exposed to the intervention. The intervention will be conducted both face to face and over telehealth. The group size will be approximately 30-40 athletes. Our intervention is a sleep and circadian protocol called SCIMA. The SCIMA protocol was developed for this study through an iterative coproduction process, involving guidance from athletes as well as recommendations from circadian, mental health and sleep experts. We also incorporated prior evidence, some existing materials and used the cognitive behavioural therapy structure to create our own practitioner/ client manual. During the coproduction process, athletes were asked during individual interviews about their capability, opportunity and motivation to carry out certain sleep behaviours proposed by the researchers using the COM-B model of behaviour change. The athletes’ responses were used as a guide for protocol development. The main guidelines of SCIMA are to establish a regular sleep–wake schedule (based on the current evidence on sleep regularity guidelines) that has been informed by individual circadian biology. The intervention contains cognitive-behavioural components to assist in maintaining this routine and includes group psychoeducation, weekly behavioural coaching, light therapy and blue light block glasses use as well as general sleep and circadian hygiene recommendations. The practitioners who would administer this manual with the athlete have the relevant training and experience in clinical work, sleep interventions and chronobiology. Further components: 1) 1x group psychoeducation session (30-40 minutes) (e.g., what the intervention involves, education about the relationship between sleep regularity, circadian rhythms and mental health, importance of maintaining these behaviours to derive benefits, healthy sleep habits such as dimming lighting in the evening, having a wind down routine) 2) 4x Individual behavioural coaching sessions (20-30 minutes weekly, 1 in person and the following 3 over zoom) (e.g., the athlete's individual goals for the intervention, what went well/ not well during the week, review of subjective sleep diaries and objective wrist monitor date) 3) The athletes will be given blue light blocking glasses for the intervention period to use one hour before their sleep onset regularity window. 4) Morning light exposure: The athletes will be given a ‘light therapy device’ to keep for the intervention period. They will be asked to either get 15 minutes of natural sunlight when they wake up or to use the light therapy device if natural sunlight is not possible. The intervention will be conducted over a period of 4 weeks as well as a prior 2-week baseline assessment. Adherence to the intervention will be measured through surveys, goal attainment scaling and both objective/ subjective measure of sleep.