BRIEF INTERVENTION TO ADDRESS BEHAVIORAL DISORDERED SLEEP: EXAMINING FACTORS RELATED TO INTERVENTION EFFICACY

Author

Danielle Elizabeth Chambers, Southern Illinois University CarbondaleFollow

Date of Award

9-1-2021

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Fehr, Karla

Abstract

Sleep disorders are highly prevalent in children and adolescents, affecting approximately 25-40% of this population. Questions about sleep are among the most frequent concerns that parents raise to their child’s pediatric medical provider. Behavioral treatments are the empirically supported treatments for addressing behavioral disordered sleep, and pediatric medical providers often endorse using such strategies. However, given the time constraints of primary care visits, such strategies are delivered in a very brief format. Whether or not these recommendations result in a change in the child’s disordered sleep symptoms has not been explored. Further, it is likely that this brief recommendation format is effective for some patients but not others. For example, children with comorbid neurodevelopmental conditions, severe sleep problems, and anxiety are less likely to respond to brief sleep interventions, and, therefore, may require a more comprehensive, time-intensive behavioral intervention. The current study aimed to explore factors related to the efficacy of a brief behavioral intervention provided via telehealth. Thirteen parents completed all portions of the study. Three were parents of children between the ages of 8 to 15 years and 10 were parents of children between the ages of 4 to 7 years (M = 6.8; SD = 2.7). All parents identified as White mothers. All children were also identified as White with 38.5% being female. Due to small sample size, quantitative analyses were not appropriate, so a qualitative examination of the data was conducted to explore relationships among participant demographics, sleep hygiene behaviors, sleep knowledge, sleep symptom severity, anxiety symptoms, and effects of the intervention. Results indicated that 37.50% of parents accurately assessed whether their child had problematic sleep. Minor variations in sleep knowledge were observed between parents who accurately identified their child’s sleep problems and those who did not (7.67 and 6.40 out of 10, respectively). Overall, participants had an average initial sleep knowledge score of 6.68, an average follow up sleep knowledge score of 7.31, and an average change in knowledge score of 0.62. Regarding effects of the intervention on sleep symptom severity, the average initial sleep symptom severity score was 50.25, the average follow up sleep severity score was 48.77, and the average change in sleep severity score was -2.00. An examination of sleep hygiene characteristics highlighted that while 81.25% of participants endorsed having a bedtime routine, almost 70% reported that the routine included an electronic device. Differences in initial sleep symptom severity and sleep knowledge scores were noted between participants who did and did not include electronic devices in their bedtime routines. The clinical implications of these findings are discussed further. Differences in intervention efficacy between participants with and without ADHD was also examined, but differences were not apparent. Intervention acceptability and feasibility were also examined. The current study demonstrated that the intervention was feasible to deliver for most participants within 10 minutes and, therefore, would be conducive to a primary care setting. Additionally, parents reported high levels of satisfaction with the content, understandability, and comprehensiveness of the treatment, which is encouraging for parents’ willingness to utilize the intervention if it was available to them. This study acted as an important initial step to determining the feasibility and acceptability of a brief behavioral sleep intervention. Clinical implications and future directions are discussed.