Investigating a Sleep Intervention for Adolescents Attending Mental Health Services

Acceptability of Intervention to Practitioners

Measured through qualitative interviews conducted with mental health practitioners and service managers (N = 13) to explore their experiences of the intervention and feasibility of delivery in practice.

Time frame: Up to 9 months post-training

Sleep Outcomes (Change From Baseline, Post-intervention and Follow-up)

Sleep outcomes were intended to be assessed using a consensus sleep diary completed by adolescent participants at three time points: baseline (2 weeks prior to intervention), post-intervention (2 weeks after intervention), and follow-up (3 months after intervention). However, only baseline data were completed by 3 participants. No post-intervention or follow-up sleep diary data were collected. This table summarizes baseline sleep outcomes only, based on the sleep efficiency score - a key sleep parameter calculated as: Sleep Efficiency (%) = (Total Sleep Time / Time in Bed) × 100 Higher scores indicate better sleep efficiency, with scores above 90% typically considered good.

Time frame: Baseline (2 weeks before intervention delivery)

Insomnia Symptoms Assessed Using Sleep Condition Indicator (Score of <16 Indicates Probable Insomnia, Higher Scores Indicate Better Sleep, Scores Range 0-32) (Change From Baseline, Post-intervention and Follow-up)

Insomnia symptoms were intended to be measured using the Sleep Condition Indicator (SCI), completed by adolescent participants at three time points: Baseline (2 weeks prior to intervention), Post-intervention (2 weeks following intervention), Follow-up (3 months post-intervention) Sleep Condition Indicator scores range from 0-32, with higher scores indicating better sleep. A score \<16 suggests probable insomnia. However, only baseline SCI scores were collected from participants. No post-intervention or follow-up data were submitted.

Time frame: Baseline (2 weeks before intervention) Baseline (2 weeks before intervention) Baseline (2 weeks before intervention)

Depression and Anxiety Symptoms Assessed by Revised Child Anxiety and Depression Scale - 25 Item Version (RCADS-25) (Change From Baseline, Post-intervention and Follow-up)

Symptoms of depression and anxiety were intended to be assessed using the Revised Child Anxiety and Depression Scale - 25 item version (RCADS-25), completed by adolescent participants at three time points: Baseline (2 weeks prior to intervention), Post-intervention (2 weeks after intervention), Follow-up (3 months after intervention) RCADS-25 provides total scores and subscale scores for anxiety and depression. The anxiety subscale includes 15 items and scores range from 0-45. The depression subscale comprises 10 items and scores range from 0-30. A total score can be calculated by summing the depression and anxiety subscales and the total scores range from 0-75. Higher scores on any subscale or the total score represent greater symptom severity. However, only baseline data were collected. No post-intervention or follow-up RCADS-25 data were submitted by any of the 3 adolescent participants

Time frame: Baseline (2-weeks before intervention delivery)

Anxiety Symptoms Measured by GAD-7 (Change From Baseline, Post-intervention and Follow-up)

Measured by Generalised Anxiety Disorder Assessment (GAD-7). The GAD-7 will be utilised to measure symptoms of anxiety. The measure consists of 7 items assessing anxiety symptoms over the previous 2 weeks. Scores range from 0-21, higher scores indicate greater symptom severity (5- mild, 10 - moderate, 15- severe). We intended to collect data at three time points: Baseline (2 weeks prior to intervention), Post-intervention (2 weeks after intervention), Follow-up (3 months after intervention) However, only 1 participant completed this measure at baseline. No post-intervention or follow-up GAD-7 data were submitted by participants.

Time frame: Baseline (2-weeks before intervention delivery)

Depression Symptoms Measured by PHQ-9 (Change From Baseline, Post-intervention and Follow-up)

Depression symptoms were intended to be measured using the Patient Health Questionnaire-9 (PHQ-9) at three time points: Baseline (2 weeks prior to intervention), Post-intervention (2 weeks after intervention), Follow-up (3 months after intervention) The PHQ-9 consists of 9 items, each scored 0-3, with total scores ranging from 0-27. Higher scores indicate more severe depressive symptoms. However, only baseline PHQ-9 data were submitted by participants. No post-intervention or follow-up data were collected.

Time frame: Baseline (2-weeks before intervention delivery)

Circadian Phase Preference Measured by Morningness/Eveningness Scale for Children

Measured by Morningness/eveningness scale for children (MESC). This 10-item measure will be used to assess circadian phase preference. Items are scored on from 1- 5 item scale and scores range from 10-42. Lower scores indicate greater eveningness (\<20) and higher scores indicate greater morningness (\>28). This item will be collected in the baseline assessment.

Time frame: Baseline only