0806 The Effect of a Sleep Promotion Program in Adolescents with Insufficient Sleep: A Randomized Controlled Trial

Abstract Introduction Adolescent sleep is compressed by early school start times and often competes with school, extracurricular, and social demands. Insufficient and mistimed weeknight sleep contributes to large shifts in weekend-weekday sleep-wake schedules, which may lead to adverse physical and mental health outcomes. The Sleep Promotion Program (SPP) is a brief, scalable, behavioral intervention that aims to increase sleep duration and regularity while building motivation and efficacy to change sleep behaviors. This secondary analysis tested whether the SPP changed actigraphy-assessed sleep. Methods Participants (ages 13-15) with insufficient and irregular sleep (N=44) were randomized to the SPP intervention (n=24) or waitlist control (n=20). The SPP included sleep psychoeducation and a face-to-face clinician session, relying on evidence-based strategies for promoting sleep within a motivational interviewing framework. Participants wore an ActiWatch during their baseline and follow-up which occurred after the intervention or the waitlist period. We hypothesized participants randomized to SPP would lengthen and stabilize sleep from baseline to follow-up compared to controls. We tested a group (intervention vs. waitlist) by time (baseline vs. follow-up) interaction on actigraphy-assessed sleep duration, timing, and regularity (weekend-weekday shift in timing) using multilevel models with a random intercept. Results We included 38 participants with at least 4 weekday nights and 1 weekend night of actigraphy (n=23 intervention, n=15 waitlist). The intervention group delayed their weeknight bedtimes (~45 minutes; b=0.69, SE=0.27, p=0.01), delayed their weeknight waketimes (~1 hour; b=0.68, SE=0.32, p=0.03), and simultaneously decreased the difference between weekend-weekday bedtimes (b=-1.1, SE=0.5, p=0.04) compared to controls (i.e., increased regularity). Weekend sleep timing and total sleep time did not change significantly. Conclusion The SPP intervention regularized weekend-weekday sleep timing in adolescents with insufficient and irregular sleep, likely driven by delaying weeknight sleep times. Given that this study was primarily conducted during the COVID-19 pandemic, when many participants reported delayed school start times, participants randomized to SPP were able to regularize their weekend-weekday sleep schedules while simultaneously adapting their weeknight sleep schedules to better fit their preferred timing. Regularizing sleep may be an attainable first step to improving sleep in adolescents. Future work will examine whether sleep regularization associates with mental health outcomes. Support (if any) K23HD087433, Pittsburgh CTSI