A Prevention Program for Insomnia in At-risk Adolescents: A Randomized Controlled Study.

Publication Type:

Journal Article


Pediatrics, Volume 147, Issue 3 (2021)


Adolescent, Cognitive Behavioral Therapy, Confidence Intervals, Depression, Disorders of Excessive Somnolence, Female, Humans, Incidence, Intention to Treat Analysis, Male, Numbers Needed To Treat, Risk, Sleep Initiation and Maintenance Disorders, Time Factors


<p><b>OBJECTIVES: </b>To prevent the future development of insomnia in at-risk adolescents.</p><p><b>METHODS: </b>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.</p><p><b>RESULTS: </b>A total of 242 adolescents with family history of insomnia and subthreshold insomnia symptoms were randomly assigned to an intervention group ( = 121; mean age = 14.7 ± 1.8; female: 51.2%) or control group ( = 121; mean age = 15.0 ± 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%; = .002; number needed to treat = 6.7; hazard ratio = 0.29; 95% confidence interval: 0.12-0.66;  = .003) over the 12-month follow-up. The intervention group had decreased insomnia symptoms ( = .03) and reduced vulnerability to stress-related insomnia ( = .03) at postintervention and throughout the 12-month follow-up. Decreased daytime sleepiness ( = .04), better sleep hygiene practices ( = .02), and increased total sleep time ( = .05) were observed at postintervention. The intervention group also reported fewer depressive symptoms at 12-month follow-up ( = .02) compared with the control group.</p><p><b>CONCLUSIONS: </b>A brief cognitive behavioral program is effective in preventing the onset of insomnia and improving the vulnerability factors and functioning outcomes.</p>

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