Optimizing Behavioral Sleep Interventions for Adolescents and Young Adults
Mary Rooney, Ph.D.
Division of Services and Intervention Research
The proposed concept encourages effectiveness research that will adapt, optimize and test empirically supported behavioral interventions designed to address common sleep problems in adolescents and young adults with a mental health disorder or who are at risk for developing a mental health disorder.
Sleep problems, defined here as short sleep duration, irregular sleep timing, and poor sleep quality, are modifiable factors that contribute to the onset, worsening, and continuation of mental health disorders. Adolescence (ages 12-17) and young adulthood (ages 18-24) are two developmental periods characterized by increased risk for sleep problems and mental health disorders. Sleep problems during these periods are associated with anxiety and depression, worsening symptoms of attention deficit hyperactivity disorder, suicidal thoughts and behaviors, and poor social, academic, and occupational functioning. In recent years, sleep problems in adolescents and young adults have been steadily worsening, with the greatest increases observed among members of racial, ethnic, and sexual and gender minority groups and those from lower socioeconomic strata. The pervasiveness and severity of these sleep problems have led the American Academy of Pediatrics, the American Medical Association, and the American Academy of Sleep Medicine to consider adolescent sleep a serious public health concern. Yet, sleep interventions for adolescents and young adults are severely understudied. In contrast to adult and child populations for which there are well established interventions for the treatment of insomnia (adults) and behavioral sleep problems (children), there are no well-established, scalable interventions for common sleep problems in adolescents and young adults that consider the unique developmental and social characteristics of these age groups (e.g., increased autonomy, heavy digital device use, social demands, shifting circadian rhythms, school schedules).
This concept encourages effectiveness research that is informed by developmental science and grounded in clearly specified empirical models of behavior and symptom change. This includes a consideration of individual, social, and/or environmental challenges associated with sleep-related behavior change and, as relevant, digital device-related behavior change. To facilitate the development of evidence-supported interventions that are relevant for the target population and appropriate for delivery in real world contexts, NIMH encourages stakeholder-informed approaches that include a youth advisory panel as well as other key stakeholders, and strategies and methods specifically designed to address sleep and mental health disparities.
Anticipated Outcomes and Products
It is anticipated that this research will yield findings that provide a robust evidence base for approaches that effectively intervene on common adolescent and young adult sleep problems, address sleep and mental health disparities, and can feasibly be delivered in real world contexts. Results are also expected to enhance our knowledge of intervention targets and key mechanisms underlying the association between changes in sleep and changes in mental health. Lastly, study results should expand our knowledge of factors and intervention approaches that support adolescent and young adult behavior change in the face of competing environmental, social, and motivational factors.