Alleviating Chronic Sleep Debt in Early Adolescents: Can a School-Based Intervention Make a Difference?

Monday, 30 July 2012: 11:35 AM

Barbara B. Richardson, PhD, RN
College of Nursing, Washington State University, Spokane, WA

Learning Objective 1: Identify negative health outcomes associated with chronic sleep deprivation in adolescents.

Learning Objective 2: Describe the use of actigraphy, a new technology that accurately measures quantity and quality of sleep.

Purpose:  Sleep deprivation, experienced by up to 80% of adolescents, results in varying degrees of daytime sleepiness, negatively impacting health, behavior, emotions, and academic achievement. Underlying causes of insufficient sleep may be related to behavioral, environmental, and /or physiological factors. The purpose of this study was to investigate an educational program designed to increase awareness of the importance of adequate sleep in 12-14 year old adolescents through implementation of a school-based curriculum.

Methods: Bruner’s  Discovery Learning model (1966) and Bronfenbrenner’s bio-ecological theory (2005), provided the framework for program development. The pre-posttest study was conducted with intervention and comparison groups; two classes of combined 7th and 8th grade students (n=48) attending an urban public middle school. Before and after conducting the Sleep for Your Health program, total sleep time (TST) was measured for seven nights using wrist actigraphy. Daytime sleepiness (DS) was measured using the Cleveland Adolescent Sleepiness Questionnaire (CASQ). Following the educational program, conducted 30 minutes weekly for six consecutive weeks, knowledge of sleep was tested and participants evaluated the program.

Results: Post intervention, student and parents demonstrated a strong understanding of sleep concepts. Mean TST in the intervention group increased from 445 to 467 minutes per night.  Most students indicated they were attempting to obtain more nightly sleep, with 55% demonstrating an increase in sleep time by an average of 65 minutes a night. Unexpectedly wide variations in sleep patterns were recorded via actigraphy. No significant relationship existed between TST and DS, or sleep quality and DS. No significant changes in mean TST or DS scores occurred in the intervention group compared to the comparison group. 

Conclusion: The program was perceived as beneficial by students, parents, and teachers. In this study, knowledge that adequate sleep is essential to physical, mental, and emotional well-being did not translate into significant behavior changes for all students.