Insomnia Chronic, Oppositional Defiant Disorder
Conditions
Brief summary
In this proposal a brief web-based cognitive behavioral treatment for insomnia (CBT-I) for children with oppositional defiant disorder (ODD) and their parents is iteratively adapted and tested for acceptability, feasibility, and preliminary efficacy.
Interventions
Standard CBT-I techniques along with modules targeting noncompliance in children with ODD and their parents.
Sponsors
Study design
Eligibility
Inclusion criteria
1. Child ages 8-17 with ODD (prior diagnosis) and insomnia 2. Child and parent English proficiency. Insomnia: 1. complaints of difficulties falling asleep, staying asleep, or early morning awakening by child report or parent observation for 3+ mos 2. daytime dysfunction (mood, cognitive, social, academic) due to insomnia 3. baseline diaries and actigraphy indicate \>30 mins. of sleep onset latency, wake after sleep onset, or early morning awakening (time between last awakening and out of bed time) on 6+ nights
Exclusion criteria
1. Parent unable to provide informed consent or child unable to provide assent 2. Family unwilling to accept random assignment 3. Child/parent participation in another randomized research project 4. Parent unable to complete forms or implement treatment procedures due to cognitive impairment 5. Child untreated medical comorbidity, including other sleep disorders (e.g., apnea, epilepsy, psychotic disorders, suicidal ideation/intent, \[frequent\] parasomnias) 6. Child psychotropic or other medications that alter sleep with the exceptions of stimulants, sleep medications, and/or melatonin 7. Child participation in non-pharmacological treatment (including CBT) for sleep outside current trial 8. Parent report of inability to undergo Holter Monitoring or actigraphy (e.g., extreme sensitivity, behavioral outbursts) 9. Other conditions adversely affecting trial participation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Child Daily Sleep Diaries | Each morning for 14-days at 0 weeks, 6 weeks, and 10 weeks | Daily diaries filled out by children with parent assistance that measure sleep efficiency, sleep onset latency, and total sleep time. Diaries also measure child behavior. |
| Parent Daily Sleep Diaries | Each morning for 14-days at 0 weeks, 6 weeks, and 10 weeks | Daily diaries filled out by parent that measure sleep efficiency, sleep onset latency, and total sleep time. Diaries also measure child behavior. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Child Heartrate Variability | during a cold-pressor task at 0 weeks, 6 weeks, 10 weeks | Child heartrate variability will be measured during the following: 1) resting state, 2) cold pressor stimulation to hand (place hand to bottom of 4° Celsius ice water) for 30 secs, 3) 3 min recovery, 4) cold pressor stimulation to other hand for 30secs, 5) resting state |
| Parent Heartrate Variability | during a cold-pressor task at 0 weeks, 6 weeks, 10 weeks | Parent heartrate variability will be measured during the following: 1) resting state, 2) cold pressor stimulation to hand (place hand to bottom of 4° Celsius ice water) for 30 secs, 3) 3 min recovery, 4) cold pressor stimulation to other hand for 30secs, 5) resting state |
| The Revised Childhood Anxiety and Depression Scale | 0 weeks, 6 weeks, 10 weeks | Measures child anxiety and depression |
| PROMIS Child Sleep Disturbance | 0 weeks, 6 weeks, 10 weeks | Measures child sleep |
| Alabama Parenting Questionnaire | 0 weeks, 6 weeks, 10 weeks | Measures parenting behaviors |
| Perceived Stress Scale | 0 weeks, 6 weeks, 10 weeks | Measures parent stress |
| Child Actigraphy | 24/7 during the 2 week assessment at 0 weeks, 6 weeks, and 10 weeks | Physiological measure of sleep efficiency, sleep onset latency, and total sleep time |
| State-Trait Anxiety Inventory | 0 weeks, 6 weeks, 10 weeks | Measures parent anxiety |
| Child Disruptive Behavior Disorders Checklist | 0 weeks, 6 weeks, 10 weeks | Measures child disruptive behaviors |
| PROMIS Adult Sleep Disturbance | 0 weeks, 6 weeks, 10 weeks | Measures parent sleep |
| Pediatric Sleep Questionnaire | 0 weeks, 6 weeks, 10 weeks | Measures child sleep apnea risk |
| Epworth Sleepiness Scale | 0 weeks, 6 weeks, 10 weeks | Measures parent sleep apnea risk |
| Beck Depression Inventory-II | 0 weeks, 6 weeks, 10 weeks | Measures parent depression |
| Parent Actigraphy | 24/7 during the 2 week assessment at 0 weeks, 6 weeks, and 10 weeks | Physiological measure of sleep efficiency, sleep onset latency, and total sleep time |
Countries
United States