Sleep Disturbance, Sleep, Depression, Suicide
Conditions
Keywords
Sleep Disturbances, Objective Sleep, Subjective Sleep Difficulties, Minority Youth
Brief summary
The goal of this clinical trial is to adapt a sleep intervention for individuals representative of all demographic groups, including those who are at the highest risk for suicidal behavior. Sleep difficulties are a promising target for youth with suicidal thoughts and behavior to focus on as a prevention measure. We aim to increase intervention acceptability and impact by adapting it for the adolescent populations at highest risk for suicidal thoughts and behavior. The research project will compare Transdiagnostic Sleep and Circadian Intervention (TranS-C), an evidence based, modularized intervention that targets a range of sleep difficulties to a treatment as usual or control condition including providing weekly sleep feedback reports from data entered into a daily sleep diary and from wearing a sleep sensing, actigraphy watch. Participants in both conditions (TranS-C vs. Sleep Feedback) will wear an actigraphy sleep watch that monitors sleep, and complete daily sleep diaries via smartphone or email. Participants in the TranS-C condition will also wear bright light (BL) and blue blocking glasses each day as well as attend weekly or biweekly sessions with a Sleep Therapist. The sleep therapist will review sleep feedback during sessions.
Detailed description
This study will adapt TranS-C+BL for at-risk adolescents using health equity-informed implementation science methods. This randomized trial will enroll 75 youth aged 12-18 at risk for STB and clinically significant sleep difficulties identified in primary care. The randomization that this study uses is a 2:1 allocation to compare TranS-C+BL Sleep Feedback vs. Sleep Feedback Alone.
Interventions
BEHAVIORALTranS-C
This intervention includes participants attending 6-8 sessions with a Sleep Therapist.
BEHAVIORALSleep Feedback
Participants are provided with an actigraphy watch that is used to monitor their sleep and activity throughout the day and complete a sleep diary daily. Along with wearing the watch they also will be provided access to their actigraphy and sleep diary graphs that document their data.
Sponsors
Children's Hospital of Philadelphia
University of Oregon
National Institute of Mental Health (NIMH)
University of Pittsburgh
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
12 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* Adolescents (12-18) * Current moderate to severe depression as measured by the PHQ-9M with a total score of greater than or equal to 11 * Current clinically significant sleep disturbance measured by the PHQ-9-M sleep item greater than or equal to 2. * English language fluency and literacy sufficient to engage in study protocol.
Exclusion criteria
* Evidence of obstructive sleep apnea, * Evidence of restless legs syndrome * Evidence of psychosis * Evidence of bipolar disorder * Evidence of a developmental disability precluding comprehension of study procedures per electronic health record and eligibility screening.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility-Attendance | From enrollment to the end of the treatment (up to 4 months) | Feasibility of interventions as by measured by the mean of number of sessions attended. Local study documents are used to track each session that was completed. |
| Feasibility-Attrition | From enrollment until withdrawal or completing treatment sessions. | Attrition will be assessed using a study-specific form reflecting participants who withdraw or are withdrawn from the TranS-C+ intervention. The proportion of patients who withdraw or are withdrawn will be calculated. |
| Acceptability-Treatment Satisfaction | 4 month | Treatment satisfaction will be measured by the patient-reported Treatment Satisfaction Questionnaire administered post-treatment. The Treatment Satisfaction Questionnaire assesses satisfaction with the treatment received and perception of progress; each item is rated on a Likert scale. Additional open-ended questions allow for participants to share feedback on strengths and weaknesses as well as any other feedback related to their satisfaction with the intervention. The Questionnaire has questions on a 1(Not at all)-7(Very Much). Questions on study clinicians are asked on a 1(Poor)-7(Superior) Likert scale. Questions on the duration of study on a 1(Much too short)-7(Much to long) Likert scale. Questions about frequency of visits on a 1(Much too infrequent)-7(Much to frequent). Questions for recommendations to other rated on a 1(Strongly recommend)-7(Strongly not recommend). Questions on future outlook rated on a 1(Very Pessimistic)-7(Very Optimistic). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Sleep Disturbance | Baseline | Self-reported sleep disturbance will be assessed via the Pediatric PROMIS Sleep Disturbance and Sleep Related Impairment Measures. The Patient-Reported Outcomes Measurement Information System is an 8-item measure. The scoring ranges from Never (1) Almost Never (2) Sometimes (3) Almost Always (4) Always (5). The PROMIS scale is scored on the T-score metric scale. The higher the participant scores more of the concept being measured. With the general population getting a score of 50 with a standard deviation of 10 |
| Depression | Baseline | Depressive symptom severity will be assessed via the self-reported PHQ-9-M. The Patient Health Questionnaire is a 13-item measure. The questions are rating on a 0(Not at all)- 3(Nearly Every day) Likert scale. Additional questions rated on a scale of Not difficult at all to Extremely difficult, along with yes/no questions. The PHQ-9M is rated on a scale from 0 to 27. Higher scores are associated with higher levels of, or more severe, depression |
| Risk for Suicidal Thoughts and Behaviors | Baseline | Suicidal thoughts and behaviors will be assessed via the C-SSRS. The Columbia-Suicide Severity Rating Scale is an 18-item measure. This measure contains yes/no questions, asking about both about suicidality over the past 3 months and lifetime. In the C-SSRS the higher the score the more risk of suicidality (0 = No risk reported (all no responses),1 - 2 = Low risk ,3 - 6 = Moderate to high risk) |
Countries
United States
Contacts
Primary ContactBrandie George-Milford, MA
Backup ContactBeth Hafer
Outcome results
None listed