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

Abstract

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