0776 A Behavioral Intervention to Enhance Sleep in School-Aged Children: Moderation by Child Routines. (12th April 2019)

• Record Type: Journal Article
• Authors: Gebre, Azeb; Hawley, Nicola; Carskadon, Mary; Raynor, Hollie; Jelalian, Elissa; Owens, Judith; Wing, Rena R; Hart, Chantelle N
• Is Part Of: Sleep. Volume 42(2019)Supplement 1
• Page Start: A311
• Page End: A312
• Publication Date: 2019-04-12
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsz067.774
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Although mounting evidence suggests that a good night's sleep has beneficial effects on children's executive, behavioral, and emotional functioning, many US school-aged children do not achieve recommendations for sleep duration. We previously demonstrated that a brief behavioral intervention can improve children's objectively estimated sleep time relative to controls; however, not all children achieved clinically meaningful changes in sleep, underscoring the need to identify factors that may promote success. We therefore examined whether household routines, which may enhance family functioning and adherence to treatment recommendations, moderated the effectiveness of the behavioral sleep intervention. Methods: Sixty-six short-sleeping (≤ 9.5 hours/day) children ages 8 to 11 years old (Mage =9.75±1.02 years, 45 female, 30 Black/African American) randomized to intervention (enhance time in bed by 1-1.5 hours/night) or control with parent-reported Child Routines Inventory (CRI) at baseline were included. The CRI is a 36-item scale providing a total score and four subscales: daily living, household responsibilities, discipline routines, and homework routines. Sleep period was assessed for one week each at baseline and 2 months post-randomization using wrist-worn actigraphy (Actiwatch 2, Respironics); standard scoring procedures were employed. Moderation analysis was performed using the PROCESS macro for SPSS. Results: Overall mean baseline sleep period was 514 ± 39 minutes/night with no differences between groups. Controlling for baseline sleep period, the intervention group had a longer sleep period at 2 months than control (b=45.93, p <.01). Treatment response was moderated by total routines score (b=1.43, p =.04). Specifically, children receiving the intervention whose families reported higher levels of routines at baseline had greater increases in sleep (b=65.34, p <.01) than those reporting fewer routines (b=26.52, p =.04). Post-hoc analyses revealed that the household responsibilities subscale score had a marginal moderating effect on treatment response (b=2.80, p =.07). Conclusion: Established household routines may better equip families to improve their children's sleep within the context of a behavioral intervention. Future work should consider the importance of including a focus on family routines to enhance treatment outcomes. Support (If Any): NIH NHLBI R01 HL092910 (PI: Hart)