Evaluation of an interactive school-based sleep education program: a cluster-randomized controlled trial

Objectives: Shortened sleep has negative consequences on adolescents' well-being. The present study evaluated an interactive school-based sleep education program (SEP) aimed at increasing adolescent sleep duration. Design and intervention: A cluster-randomized controlled trial with 12 clusters (classes) was used. The intervention group received a SEP and the active control group received a healthy living program (HLP). Both groups underwent a 4-week class-based education program. The SEP students learned about the importance of sleep, the barriers to getting enough sleep, and how to improve their time management to increase their sleep opportunity. The HLP students learned about various health-related topics not including sleep. Participants: A total of 210 students (mean age = 14.04 +/- 0.32 years) were randomly assigned to the SEP (n = 102) or the HLP (n = 108) group, with 6 classes per group. Measurements: Sleep (actigraphicallymeasured), sleep knowledge, and time usage were assessed using linear mixed models at three time points: baseline, immediately after intervention, and 1-month follow-up. Results: Sleep knowledge improved at follow-up in the SEP relative to the HLP group (p =.017). Although students were receptive of the program and self-reported the intention to create more time for sleep, no changes in sleep were found following the SEP. Some benefit may have been masked by exam preparations at the follow-up evaluation. Conclusions: Sleep education alone may not be sufficient to change sleep behavior. A combination of sleep education, starting school later, and parental involvement may be needed to encourage and enable changes in adolescent sleep duration. (C) 2019 The Authors. Published by Elsevier Inc. on behalf of National Sleep Foundation. open access