The Effect of Sleep Extension in Teenage Girls at a College Preparatory High School

Study Overview
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Brief Summary
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If teenagers attain the recommended amount of sleep (9-9.5 hours per night), they will feel less stress and have better athletic and academic performance. The investigators will track students sleep patterns before and after a sleep intervention where they are given a packet of sleep tips and encouraged to improve their sleep hygiene. Outcomes include stress levels, academic/athletic performance, and sleep cycle data from the sleep tracking watch.

Detailed Description
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A. PURPOSE OF THE STUDY To determine the effect of sleep extension on stress levels, cognitive function, and fitness in teenage girls. B. HYPOTHESIS / SPECIFIC AIMS If teenagers attain the recommended amount of sleep (9-9.5 hours per night), they will feel less stress and have better athletic and academic performance. Primary Objective: • The investigators will evaluate stress with a validated questionnaire before and after sleep extension (increased total sleep time per night). Secondary Objectives: The investigators will evaluate physical fitness and endurance with standardized testing before and after sleep extension. The investigators will measure several sleep variables (total sleep time, sleep efficiency, sleep onset latency, sleep-wake cycle pattern, sleepiness) before and after sleep extension. The investigators will evaluate the association between academic performance (Grade Point Average (GPA) and average total sleep time per night. Intervention: Sleep extension: Increasing nightly total sleep time (goal of 9-9.5 hours per night) by improving sleep hygiene, daily exercise, etc. In a prospective cohort study, up to 40 otherwise healthy teenage girls age 14-18 years at DSHA High School will be approached for consent to participate in the study. Upon consent they will complete the Insomnia Severity Index (ISI), Epworth Sleepiness Scale for Children and Adolescents (ESS-ChAD) and Perceived Stress Scale (PSS) questionnaires and will be issued an actigraphy watch to monitor their sleep-wake cycles daily at home for 2 weeks. They will also keep a sleep diary during the study period. After the 2 weeks of actigraphy, subjects will have the data from the actigraphy watch downloaded and submit their sleep diary. They will be given sleep hygiene recommendations to try to attain 9-9.5 hours of sleep per night (sleep extension), if not already sleeping this amount. They will then be given a different actigraphy watch to wear and another sleep diary to log their total sleep time for 4 more weeks. After the 4 weeks, the actigraphy watch will be returned, the actigraphy data will be downloaded and the sleep diary data will be collected. Subjects will complete the ESS-ChAD and PSS upon conclusion of the study. Subjects will be offered a report of their sleep and activity data after completing the sleep extension period. If there is a gap of more than 4 weeks between actigraphy use and the second fitness test, the investigators will ask participants to complete another 1-week sleep diary prior to testing. All study activities except downloading the actigraphy watch data will occur at Divine Savior Holy Angels High School (DSHA).

Official Title
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The Effect of Sleep Extension in Teenage Girls at a College Preparatory High School

Conditions
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Sleep Hygiene, Sleep

Intervention / Treatment
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* Behavioral: Sleep Hygiene tips


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1. Female students age 14-18 yrs (DSHA students ranging from Freshman to Senior year) Exclusion Criteria: Subjects and/or parent/guardian unable to read, understand or speak English Subjects unable to undergo fitness testing Subjects who are pregnant or become pregnant during the course of the study

Ages Eligible for Study
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Minimum Age: 14 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Study group<br>Study group | Behavioral: Sleep Hygiene tips<br>* Students receive a packet of information on how to improve their sleep habits and hygiene.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Stress Levels | Perceived Stress Scale (PSS); 10 questions, scores between 0-4; higher score shows higher stress levels | Week 0 (before actigraphy) and Week 6 (after both actigraphy watch courses) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Physical Fitness | Standardized PACER (Progressive Aerobic Cardiovascular Endurance Run) testing; administered in the Fall and Spring of each school year; a series of timed runs that get progressively faster; Out of 25 laps, higher score is better with more laps completed | 6 months (end of August to end of February) | 
| Sleepiness | Difference in sleepiness before and after sleep extension intervention. Measured with the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD); scale of 0 to 3; higher score means more likely to fall asleep in a given situation | 6 weeks, 2 before intervention and 4 after | 
| Total Sleep Time | Difference in total sleep time before and after sleep extension intervention | 6 weeks, 2 before intervention and 4 after | 
| Sleep Latency | Difference in sleep latency before and after sleep extension intervention | 6 weeks, 2 before intervention and 4 after | 
| Academic performance | Grade point average (GPA); 0.0-4.0 scale, higher is better | First semester 4 months (August 19th, 2019 - December 20th, 2019) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Actigraphy, Sleep Extension