A prevention program for insomnia in at-risk adolescents: A randomized controlled study

Abstract

OBJECTIVES: To prevent the future development of insomnia in at-risk adolescents. METHODS: A randomized controlled trial comparing 4 weekly insomnia prevention program with a nonactive control group. Subjects were assessed at baseline, postintervention, and 6 and 12 months after intervention. Assessors were blinded to the randomization. Analyses were conducted on the basis of the intention-to-treat principles. RESULTS: A total of 242 adolescents with family history of insomnia and subthreshold insomnia symptoms were randomly assigned to an intervention group (n = 121; mean age = 14.7 6 1.8; female: 51.2%) or control group (n = 121; mean age = 15.0 6 1.7; female: 62.0%). There was a lower incidence rate of insomnia disorder (both acute and chronic) in the intervention group compared with the control group (5.8% vs 20.7%; P =.002; number needed to treat = 6.7; hazard ratio = 0.29; 95% confidence interval: 0.12-0.66; P =.003) over the 12-month follow-up. The intervention group had decreased insomnia symptoms (P =.03) and reduced vulnerability to stress-related insomnia (P =.03) at postintervention and throughout the 12-month follow-up. Decreased daytime sleepiness (P =.04), better sleep hygiene practices (P =.02), and increased total sleep time (P =.05) were observed at postintervention. The intervention group also reported fewer depressive symptoms at 12-month follow-up (P =.02) compared with the control group. CONCLUSIONS: A brief cognitive behavioral program is effective in preventing the onset of insomnia and improving the vulnerability factors and functioning outcomes.