Up to 72% of adolescents with ADHD portray sleep problems. The most common sleep difficulties in adolescents with ADHD are initial insomnia, nocturnal awakenings, non-restorative or restless sleep. These difficulties seem to be causally related to increased ADHD symptom impairment, oppositional and depressive symptomatology, and functional impairments in daily life, resulting in a vicious circle of sleep problems and impairment. Thus, reducing sleep problems is an important intervention target. However, to date there is no evidence-based cognitive behavioral sleep treatment available. Sleep-focused treatments need adaptation towards this developmental phase/disorder for effectiveness, as ADHD and sleep problems are bi-directional. Therefore, a blended treatment targeting the core deficits integrating motivational interviewing, planning skills and sleep interventions is needed. Thus, the aim of this project is testing the short and 3-4 months follow-up effectiveness of the blended cognitive behavioral sleep intervention in adolescents with ADHD.
To test effectiveness a randomized controlled trial in conducted in which adolescents with ADHD and sleep problems are randomized to either their Treatment as Usual for ADHD or their Treatment as usual for ADHD combined with the SIESTA cognitive behavioral sleep interventions. Effects on sleep, ADHD behavior and co-occuring problems are assessed at pretest, post test and at 3-4 months follow-up.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
92
SIESTA is a CBT sleep training for adolescents with ADHD with a focus on sleep hygiene, motivational interviewing and planning and organization.
Participants continue their treatment as usual for ADHD.
UPC Leuven
Leuven, Vlaams Brabant, Belgium
Sleep Architecture Objective TST [Total Sleep Time] Pre-test to Post-test
objective (actigraphy) sleep architecture (specified as TST in hours and minutes)
Time frame: From pre-test to post-test (+/-8 weeks)
Sleep Architecture Objective SOL [Sleep Onset Latency] Pre-test to Post-test
objective (actigraphy) sleep architecture (specified as SOL in hours and minutes)
Time frame: From pre-test to post-test (+- 8 weeks)
Sleep Architecture Objective SE [Sleep Efficiency] Pre-test to Post-test
objective (actigraphy) sleep architecture (specified as SE = TST/time in bed in percentage)
Time frame: From pre-test to post-test (+- 8 weeks)
Sleep Architecture Objective NoA [Number of Awakenings] Pre-test to Post-test
Sleep architecture objective (actigraphy) sleep architecture (specified as Number of Awakenings)
Time frame: From pre-test to post-test (+- 8 weeks)
Sleep Architecture Subjective TST [Total Sleep Time] Pre-test to Post-test
subjective (sleep logs) sleep architecture (specified as TST in hours and minutes)
Time frame: From pre-test to post-test (+- 8 weeks)
Sleep Architecture Subjective SOL [Sleep Onset Latency] Pre-test to Post-test
subjective (sleep logs) sleep architecture (specified as SOL in hours and minutes)
Time frame: From pre-test to post-test (+- 8 weeks)
Sleep Architecture Subjective SE [Sleep Efficiency] Pre-test to Post-test
subjective (sleep logs) sleep architecture (specified as SE = TST/time in bed in percentage)
Time frame: From pre-test to post-test (+- 8 weeks)
Sleep Architecture Subjective NoA [Number of Awakenings] Pre-test to Post-test
subjective (sleep logs) sleep architecture (specified as NoA: Number of Awakenings)
Time frame: From pre-test to post-test (+- 8 weeks)
Sleep Architecture Objective TST [Total Sleep Time] Pre-test to Follow-up
objective (actigraphy) sleep architecture (specified as TST in hours and minutes)
Time frame: From pre-test to follow-up (+-3 months after posttest)
Sleep Architecture Objective SOL [Sleep Onset Latency] Pre-test to Follow-up
objective (actigraphy) sleep architecture (specified as SOL in hours and minutes)
Time frame: From pre-test to follow-up (+-3 months after posttest)
Sleep Architecture Objective SE [Sleep Efficiency] Pre-test to Follow-up
objective (actigraphy) sleep architecture (specified as SE = TST/time in bed in percentage)
Time frame: From pre-test to follow-up (+-3 months after posttest)
Sleep Architecture Objective NoA [Number of Awakenings] Pre-test to Follow-up
objective (actigraphy) sleep architecture (specified as NoA: Number of Awakenings)
Time frame: From pre-test to follow-up (+-3 months after posttest)
Sleep Architecture Subjective TST [Total Sleep Time] Pre-test to Follow-up
subjective (sleep logs) sleep architecture (specified as TST in hours and minutes)
Time frame: From pre-test to follow-up (+-3 months after posttest)
Sleep Architecture Subjective SOL [Sleep Onset Latency] Pre-test to Follow-up
subjective (sleep logs) sleep architecture (specified as SOL in hours and minutes)
Time frame: From pre-test to follow-up (+-3 months after posttest)
Sleep Architecture Subjective SE [Sleep Efficiency] Pre-test to Follow-up
subjective (sleep logs) sleep architecture (specified as SE = TST/time in bed in percentage)
Time frame: From pre-test to follow-up (+-3 months after posttest)
Sleep Architecture Subjective NoA [Number of Awakenings] Pre-test to Follow-up
subjective (sleep logs) sleep architecture (specified as NoA: Number of Awakenings)
Time frame: From pre-test to follow-up (+-3 months after posttest)
Sleep Problems SSHS [School Sleep Habits Survey] [ Pre-test to Post-test
subjective sleep problems assessed by questionnaires (SSHS) School Sleep Habits Survey: questions are scored on a 5-point Likert scale, with higher scores indicating a worse outcome, minimum 10 - maximum 50
Time frame: From pre-test to post-test (+- 8 weeks)
Sleep Problems CSRQ [Chronic Sleep Reduction Questionnaire] Pre-test to Post-test
subjective sleep problems assessed by questionnaires (CSRQ) Chronic Sleep Reduction Questionnaire: questions are scored on a 3-point Likert scale, with higher scores indicating a worse outcome, minimum 20 - maximum 60
Time frame: From pre-test to post-test (+- 8 weeks)
Sleep Problems CSHQ [Children Sleep Habits Questionnaire] Pre-test to Post-test
subjective sleep problems assessed by questionnaires (CSHQ) Children Sleep Habits Questionnaire: questions are scored on a 3-point Likert scale, with higher scores indicating a worse outcome, minimum 33 - maximum 99
Time frame: From pre-test to post-test (+- 8 weeks)
Sleep Problems SSHS [School Sleep Habits Survey] Pre-test to Follow-up
subjective sleep problems assessed by questionnaires (SSHS) School Sleep Habits Survey: questions are scored on a 5-point Likert scale, with higher scores indicating a worse outcome, minimum 10 - maximum 50
Time frame: From pre-test to follow-up (+-3 months after posttest)
Sleep Problems CSRQ [Chronic Sleep Reduction Questionnaire] Pre-test to Follow-up
subjective sleep problems assessed by questionnaires (CSRQ) Chronic Sleep Reduction Questionnaire: questions are scored on a 3-point Likert scale, with higher scores indicating a worse outcome, minimum 20 - maximum 60
Time frame: From pre-test to follow-up (+-3 months after posttest)
Sleep Problems CSHQ [Children Sleep Habits Questionnaire] Pre-test to Follow-up
subjective sleep problems assessed by questionnaires (CSHQ) Children Sleep Habits Questionnaire: questions are scored on a 3-point Likert scale, with higher scores indicating a worse outcome, minimum 33 - maximum 99
Time frame: From pre-test to follow-up (+-3 months after posttest)
ASHSr [Revised Adolescent Sleep Hygiene Scale] Pre-test to Post-test
subjective sleep hygiene assessed by questionnaires (ASHSr) Revised Adolescent Sleep Hygiene Scale: questions are scored on a 6-point Likert scale, with higher scores indicating a better outcome, minimum 1 - maximum 6
Time frame: From pre-test to post-test (+- 8 weeks)
ASHSr [Revised Adolescent Sleep Hygiene Scale] Pre-test to Follow-up
subjective sleep hygiene assessed by questionnaires (ASHSr) Revised Adolescent Sleep Hygiene Scale: questions are scored on a 6-point Likert scale, with higher scores indicating a better outcome, minimum 1 - maximum 6
Time frame: From pre-test to follow-up (+-3 months after posttest)
DBDRS [Disruptive Behavior Disorders Rating Scale] ADHD Symptoms Pre-test to Post-test
Assessed by parents (DBDRS) Disruptive Behavior Disorders Rating Scale: questions are scored on a 4-point Likert scale, with higher scores indicating a worse outcome, minimum 0 - maximum 54
Time frame: From pre-test to post-test (+- 8 weeks)
DBDRS [Disruptive Behavior Disorders Rating Scale] ADHD Symptoms Pre-test to Follow-up
Assessed by parents (DBDRS) Disruptive Behavior Disorders Rating Scale: questions are scored on a 4-point Likert scale, with higher scores indicating a worse outcome, minimum 0 - maximum 54
Time frame: From pre-test to follow-up (+-3 months after posttest)
CBQ [Conflict Behavior Questionnaire] Parent-adolescent Conflict Pre-test to Post-test
Assessed by parents (CBQ) Conflict Behavior Questionnaire: rated true-false, minimum 0 - maximum 20, higher scores indicate worse outcome
Time frame: From pre-test to post-test (+- 8 weeks)
CBQ [Conflict Behavior Questionnaire] Parent-adolescent Conflict Pre-test to Follow-up
Assessed by parents (CBQ) Conflict Behavior Questionnaire: rated true-false, minimum 0 - maximum 20, higher scores indicate worse outcome
Time frame: From pre-test to follow-up (+-3 months after posttest)
HPC [Homework Problems Checklist] Homework Problems Pre-test to Post-test
Assessed by parents (HPC) : rated on a 4-point Likert scale, minimum 0 - maximum 60, higher scores indicate worse outcome
Time frame: From pre-test to post-test (+- 8 weeks)
CPS [Classroom Performance Scale] Academic Competence Pre-test to Post-test
Assessed by teacher (CPS) Classroom Performance Scale: rated on a 5-point Likert scale, minimum 13 - maximum 65, higher scores indicate worse outcome
Time frame: From pre-test to post-test (+- 8 weeks)
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HPC [Homework Problems Checklist] Homework Problems Pre-test to Follow-up
Assessed by parents (HPC) Homework Problems Checklist: rated on a 4-point Likert scale, minimum 0 - maximum 60, higher scores indicate worse outcome
Time frame: From pre-test to follow-up (+-3 months after posttest)
CPS [Classroom Performance Scale] Academic Competence Pre-test to Follow-up
Assessed by teacher (CPS) Classroom Performance Scale: rated on a 5-point Likert scale, minimum 13 - maximum 65, higher scores indicate worse outcome
Time frame: From pre-test to follow-up (+-3 months after posttest)
DBDRS [Disruptive Behavior Disorders Rating Scale] Oppositional-defiant Disorder Pre-test to Post-test
Assessed by parents (DBDRS) Disruptive Behavior Disorders Rating Scale: rated on a 4-point Likert scale, minimum 0 - maximum 24, higher scores mean worse outcome
Time frame: From pre-test to post-test (+- 8 weeks)
SCARED-R [Screen for Child Anxiety Related Emotional Disorders Comorbidities] Anxiety Pre-test to Post-test
Assessed by adolescent (SCARED-R) Screen for Child Anxiety Related Emotional Disorders: rated on a 3-point Likert scale, minimum 0 - maximum 82, higher scores indicate worse outcome
Time frame: From pre-test to post-test (+- 8 weeks)
CDI [Children's Depression Inventory] Depression Pre-test to Post-test
Assessed by adolescent (CDI-2) Children's Depression Inventory, Second Edition: rated on a 3-point Likert scale, minimum 0 - maximum 56, higher scores indicate worse outcome
Time frame: From pre-test to post-test (+- 8 weeks)
DBDRS [Disruptive Behavior Disorders Rating Scale] Oppositional-defiant Disorder Pre-test to Follow-up
Assessed by parents (DBDRS) Disruptive Behavior Disorders Rating Scale: rated on a 4-point Likert scale, minimum 0 - maximum 24, higher scores mean worse outcome
Time frame: From pre-test to follow-up (+-3 months after posttest)
SCARED-R [Screen for Child Anxiety Related Emotional Disorders] Anxiety Pre-test to Follow-up
Assessed by adolescent (SCARED-R) Screen for Child Anxiety Related Emotional Disorders: rated on a 3-point Likert scale, minimum 0 - maximum 82, higher scores indicate worse outcome
Time frame: From pre-test to follow-up (+-3 months after posttest)
CDI [Children's Depression Inventory] Depression Pre-test to Follow-up
Assessed by adolescent (CDI-2) Children's Depression Inventory, Second Edition: rated on a 3-point Likert scale, minimum 0 - maximum 56, higher scores indicate worse outcome
Time frame: From pre-test to follow-up (+-3 months after posttest)