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

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 ± 1.8; female: 51.2%) or control group ( n = 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%; 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.
Competing Interests: POTENTIAL CONFLICT OF INTEREST: Dr Wing received personal fees from Eisai Co, Ltd, for delivering a lecture and sponsorship from Lundbeck HK Ltd. Dr Morin also served on advisory boards for Merck, Eisai, and Pfizer, has received research support from Idorsia and Canopy Health, and owns equity in BeHealth Solutions. Dr Zhang has provided consultancy for BestCare and SuMian BioTech Co, Ltd; the other authors have indicated they have no potential conflicts of interest to disclose.
(Copyright © 2021 by the American Academy of Pediatrics.)