Preventing Sleep Deprivation in a 24/7 Society: A Universal School-Based Intervention for Adolescents

Introduction: Growing evidence shows that adolescents are at risk for sleep deprivation, which has serious consequences on adolescents´ functioning, including emotional and physical health, and school achievement. School-based interventions to prevent sleep deprivation are struggling to achieve behavioral changes, even when motivation is targeted. This might be due to adolescents prioritizing obligations (e.g. school homework) or more rewarding leisure activities over sleep. The present intervention targeted barriers adolescents may encounter when trying to change their sleep behaviors, such as use of information and communication technology (ICT), stress due to schoolwork, and extracurricular activities. In addition to sleep education, components included time management training and an ongoing discussion about ICT use. The aim of this study was to evaluate the effectiveness of the intervention both in the short and long-term.

Methods: Participants were 222 high school students (age 13-15, 60% girls). The intervention consisted of 5x45 min classes (over 6 to 7 weeks). Data were collected at baseline (2 weeks before the intervention start), during the intervention (weekly), and at 1-year follow-up (planned in the spring 2017). Weekly measures included, a sleep diary for school-week and weekend sleep duration, mobile usage, and motivation to change; pre- post-intervention measures included, sleep hygiene, perceived stress, and mood. We performed repeated measures ANOVA. At 1-year follow-up we will compare the intervention group to a cohort of adolescents (N = 2700, age 13-15) followed longitudinally over one year.

Results: Sleep knowledge (F(1, 178) 133.04, p < .001) and sleep hygiene (F(1, 193) 6.38, p = .012) significantly improved. Sleep duration improved only for adolescents who reported short sleep duration (i.e. less than 7 h, risk group) at baseline (F(6, 186) 5.18, p < .001). Adolescents in the risk group also reported more use of technology at baseline, which decreased for the whole group after the intervention (χ²(1)=4.67, p = .044). Similarly, adolescents reported lower perceived stress at the end of the intervention (F(1, 181) 3.85, p = .05). Motivation to change generally decreased (F(4.12, 523.87) 6.205, p < .001), but not for the risk group (p = .67).

Conclusions: Short term results show that the intervention had an effect on the target behaviors, especially for the risk group. However, the 1-year follow-up will be crucial to evaluate the preventive effect of the intervention. That is, whether the incidence of sleep deprivation is lower in the intervention as compared to the comparison group.