Is improving sleep and circadian problems in adolescence a pathway to improved health? A mediation analysis

• Published in: Journal of consulting and clinical psychology Vol. 87; no. 9; p. 757
• Main Authors: Dong, Lu, Gumport, Nicole B, Martinez, Armando J, Harvey, Allison G
• Format: Journal Article
• Language: English
• Published: United States 01.09.2019
• Subjects: Adolescent; Child; Chronotherapy - methods; Circadian Rhythm - physiology; Female; Humans; Male; Motivational Interviewing - methods; Patient Education as Topic - methods; Psychotherapy - methods; Sleep - physiology; Sleep Wake Disorders - therapy; Sleepiness; Treatment Outcome
• DOI: 10.1037/ccp0000423

The present study tested whether improvements in sleep and circadian problems mediate the effect of a novel transdiagnostic sleep and circadian intervention (TranS-C) on improvements in 5 health domains (emotional, cognitive, behavioral, social, and physical) in community-residing, evening chronotype adolescents who were at risk for problems in these 5 health domains. Participants were 176 adolescents (age mean [SD] = 14.77 [1.84] years; 58% female) who were randomized to receive 6 sessions of TranS-C or psychoeducation. Putative mediators tested were eveningness, weekday-weekend discrepancy in total sleep time and waketime, daytime sleepiness, Pittsburgh Sleep Quality Index score, and parent-reported sleep-wake problems. Risk in 5 health domains was measured using adolescent self-reported questionnaires, parent-reported Child Behavior Checklist, and ecological momentary assessment (EMA) of problems in the 5 health domains. Reduced eveningness mediated the effects of TranS-C on reducing both self-reported and parent-reported risk in the 5 health domains. Reduction in daytime sleepiness mediated the effects of TranS-C on parent-reported risk in the 5 health domains. Reduction in parent-reported sleep-wake problems mediated the effects of TranS-C on self-reported, parent-reported, and EMA-assessed risk in the 5 health domains. Results did not support the other hypothesized mediators. TranS-C exerts effects on reducing risk in multiple mental and physical health domains through reducing sleep and circadian problems in evening chronotype adolescents. Further research of TranS-C in other samples to assess its benefits for sleep and circadian problems as well as mental and physical health is warranted. (PsycINFO Database Record (c) 2019 APA, all rights reserved).