Triple Vulnerability? Circadian Tendency, Sleep Deprivation and Adolescence
Condition: Eveningness/Sleep
MeSH terms: Sleep Deprivation
Study type: Interventional

Summary: 
      There is an urgent need to identify modifiable mechanisms contributing to risk and
      vulnerability among youth. The investigators test the hypothesis that eveningness, the
      tendency to go to sleep late and wake late, is an important contributor to, and even cause
      of, vicious cycles that escalate vulnerability and risk among youth. This study seeks to
      determine whether two interventions to reduce eveningness can reduce risk and confer
      resilience in critical aspects of health, development and functioning in youth.
    

Detailed description: 
      Teens who exhibit a circadian tendency toward eveningness ('night-owls') follow a delayed
      sleep schedule, increasing activity later in the day and both going to sleep and getting up
      later, compared to morning-types ('larks'). The circadian tendency toward eveningness during
      adolescence arises from a confluence of psychosocial, behavioral and biological factors and
      is an important contributor to, and maybe even cause of, vicious cycles that escalate
      vulnerability and risk for poor health and major forms of psychopathology. Indeed, an evening
      circadian tendency has been associated with a wide range of adverse effects including poorer
      health, poorer academic performance, poorer self-regulation, greater use of substances,
      greater tendency for impulsivity, more depression and anxiety, greater emotional instability
      and more aggressive and antisocial behavior. While the biological shift toward eveningness
      during puberty may be difficult to modify, the psychosocial and behavioral contributors are
      modifiable. Moreover, modifying these contributors will eliminate key factors that exacerbate
      the biological shift. The proposed research will advance current knowledge on the role of
      eveningness as a mechanism contributing to poorer outcomes during adolescence. The
      investigators aim to reduce eveningness among 10-18 year olds via an intervention which
      integrates evidence-based treatments derived from basic research on the circadian system
      (Treatment 1) compared to a psychoeducational intervention that highlights the interplay
      between sleep, diet, exercise and stress (Treatment 2). The investigators will randomly
      allocate adolescents with an evening circadian tendency, and who are 'at risk' in at least
      one of five health domains (emotional, cognitive, behavioral, social, physical), to either:
      (a) Treatment 1 (n = 86) or (b) Treatment 2 (n = 86). Measures will be taken pre-treatment,
      post-treatment, and at 6 and 12 months post-treatment. This research is a first step within a
      longer term plan to accelerate knowledge on the potentially powerful positive effects, for
      the developing neural system, of simple, disseminable psychosocial interventions specifically
      designed to target modifiable risk factors across adolescence.
    

Intervention name(s): Cognitive Behavior Therapy for Insomnia, Interpersonal and Social Rhythms Therapy, Chronotherapy; Psychoeducation
Intervention type(s): Behavioral; Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Risk: Emotional, Cognitive, Behavioral, Social, Physical