The purpose of this research study is to compare (vs. treatment as usual) a brief (6-session), empirically supported, and highly disseminable version of digital (i.e., smartphone or web-based) cognitive behavioral therapy for insomnia (dCBT-I), called SleepioTM, in suicidal adolescents with co-occurring insomnia during the high-risk post-hospitalization period. Suicide is the 2nd leading cause of death among adolescents. Sleep problems, such as insomnia symptoms-the most common sleep problem in youth-may be a particularly promising treatment target to reduce suicide risk in adolescents. The investigators propose to test the feasibility, acceptability, and effectiveness of dCBT-I in a two-site (Rutgers and Old Dominion University) pilot study trial. Adolescents, 14-18 years-old, recently hospitalized for suicide risk with co-occurring insomnia (n=80, 50% at each site), will receive either dCBT-I (six weekly, 20-minute sessions) plus post-hospitalization treatment-as-usual (TAU) or TAU alone. Adolescents will complete assessments pre-treatment, during the treatment phase including at the end of treatment, and 1-month follow-up post-treatment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
80
Sleepio is a mobile Digital Cognitive Behavior Therapy for Insomnia (dCBT-I) app.
Treatment as usual as part of standard inpatient care, and any outpatient care received.
Rutgers University Behavioral Healthcare
Piscataway, New Jersey, United States
RECRUITINGChildren's Hospital of The King's Daughters
Norfolk, Virginia, United States
RECRUITINGInsomnia severity
Insomnia Severity Index (same measure as baseline) assessed weekly from the beginning of treatment until the treatment is complete (or a maximum of 12 weeks to match assessment with the TAU group).
Time frame: Up to 12 weeks
Suicidal thoughts
Suicide ideation severity will be measured weekly with the Beck Suicide Ideation Scale (same measure as baseline) until the end of treatment.
Time frame: Up to 12 weeks
Sleep efficiency
Sleep efficiency (SE), percent of time in bed spent asleep, assessed via Actiwatch.
Time frame: Daily through study completion, up to 12 weeks
Sleep Onset Latency
Sleep onset latency (SOL): how many minutes it takes to fall asleep, assessed via Actiwatch device
Time frame: Daily throughout the study (12 weeks)
Daily Suicidal Thoughts
Daily reports of suicide ideation from EMA
Time frame: Daily through study completion, up to 12 weeks
Wake after sleep onset
Wake after sleep onset (WASO): total amount of time awake during the night, assessed via Actiwatch wearable.
Time frame: Daily through study completion, up to 12 weeks
Subjective sleep quality
Sleep quality: subjective ratings on 1=very poor to 5=very good, assessed via ecological momentary assessment.
Time frame: Daily through study completion, up to 12 weeks
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