0992 DOES A BRIEF SLEEP INTERVENTION FOR STUDENTS STARTING ELEMENTARY SCHOOL IMPROVE CHILD AND PARENT OUTCOMES? A RANDOMIZED CONTROLLED TRIAL

Abstract

Introduction: Identifying and treating sleep problems in the first year of elementary school using a brief, behavioral intervention has demonstrated efficacy in reducing sleep problems and has positive roll‐on benefits for child psycho‐social health, behavior and parent mental health up to 12 months. However, whether such benefits present when the same intervention is delivered by school nurses remains unknown. We aimed to determine whether a brief, behavioral sleep intervention improves child psychosocial health (primary outcome), sleep, and behavior, learning and parent mental health in children transitioning to elementary school. Methods: Design: A translational, effectiveness randomized controlled trial nested within a population survey of parents of school entry children in 46 Melbourne primary schools. Participants: Children with moderate/severe sleep problems. Intervention: 1‐2 consultations between parents and a school nurse trained in flexible yet standardized sleep management techniques. Controls received “usual school nurse care”. Outcomes: (1) Parent‐reported child psychosocial health (PedsQL, primary outcome), sleep, behavior (SDQ) and learning (WIAT‐II) and parent mental health (DASS‐21) at 6 and 12 months post‐randomization. Analyses: Intention‐to‐treat analysis using linear and logistic regression, adjusting for confounders; generalized odds ratios for DASS. Results: Eighty one percent (5323 / 6635) of parents completed the survey. Child sleep problems were common (23% mild, 13% moderate/ severe); 334 (60% of those eligible) families entered the trial. Compared to controls at 6 months, intervention families reported fewer child sleep problems (53% vs. 35%, OR=0.49, 95%CI 0.32 to 0.76, p=0.002), less bedtime delay (mean diff=9min, 95% CI 1min to 18min p= 0.03) and longer school night sleep duration (mean diff= 10min, 95% CI 1min to 19min, p=0.03) and parents were less likely to report poor mental health, particularly depressive symptoms (OR 0.7, 0.6 to 1.0, p=0.03). However, children had similar psychosocial health, learning and behavior outcomes, and all 12 month outcomes were similar. Conclusion: A brief sleep intervention program, delivered soon after school entry by school nurses, initially improved children's sleep problems and parent depressive symptoms, but benefits did not exist at 1 year post‐randomization.