Anxiety Treatment and Targeted Sleep Enhancement to Address Sleep Disturbance in Pre/Early Adolescents with Anxiety

• Published in: Journal of clinical child and adolescent psychology 2019-01, Vol.48 (sup1), p.S284-S297
• Main Authors: McMakin, Dana L, Ricketts, Emily J, Forbes, Erika E, Silk, Jennifer S, Ladouceur, Cecile D, Siegle, Greg J, Milbert, Melissa, Trubnick, Laura, Cousins, Jennifer C, Ryan, Neal D, Harvey, Allison G, Dahl, Ronald E
• Format: Article
• Language: English
• Subjects: Actigraphy; Adjustment; Adolescent; Adolescents; Anxiety; Anxiety disorders; Anxiety Disorders - psychology; Anxiety Disorders - therapy; Behavior modification; Child; Circadian rhythm; Clinical significance; Cognitive behavioral therapy; Diaries; Early Adolescents; Emotional Adjustment; Female; Humans; Male; Mental health; Minority & ethnic groups; Patient-centered care; Separation anxiety; Sleep; Sleep disorders; Sleep Wake Disorders - psychology; Sleep Wake Disorders - therapy; Social anxiety
• ISSN: 1537-4416; 1537-4424
• DOI: 10.1080/15374416.2018.1463534

Sleep disturbance is prevalent in anxious youth and prospectively predicts poor emotional adjustment in adolescence. Study 1 examined whether anxiety treatment improves subjective and objective sleep disturbance in anxious youth. Study 2 examined whether a sleep intervention called Sleeping TIGERS can further improve sleep following anxiety treatment. Study 1 examined 133 youth (ages 9-14; 56% female; 11% ethnic/racial minority) with generalized, social, or separation anxiety over the course of anxiety treatment (cognitive behavioral treatment or client-centered treatment). Sleep-related problems (parent-, child-report) and subjective (diary) and objective (actigraphy) sleep patterns were assessed across treatment in an open trial design. Study 2 included 50 youth (ages 9-14; 68% female; 10% ethnic/racial minority) who continued to report sleep-related problems after anxiety treatment and enrolled in an open trial of Sleeping TIGERS. Pre- and postassessments duplicated Study 1 and included the Focal Interview of Sleep to assess sleep disturbance. Study 1 demonstrated small reductions in sleep problems and improvements in subjective sleep patterns (diary) across anxiety treatment, but outcomes were not deemed clinically significant, and 75% of youth stayed above clinical cutoff. Study 2 showed clinically significant, large reductions in sleep problems and small changes in some subjective sleep patterns (diary). Anxiety treatment improves, but does not resolve, sleep disturbance in peri-pubertal youth, which may portend risk for poor emotional adjustment and mental health. The open trial provides preliminary support that Sleeping TIGERS can improve sleep in anxious youth to a clinically significant degree.