A school-based sleep hygiene education program for adolescents in Japan: a large-scale comparative intervention study

Sleep hygiene education involves promoting good sleep habits in all aspects of lifestyle and behavior. In this study, we evaluated the effects of a sleep hygiene education program for Japanese high school students who did not have insomnia symptoms.Tenth-grade students (N = 2815; intervention, n = 1347; control, n = 1468) from 16 high schools in a provincial city in Japan participated in this cluster-controlled trial. In this program, teachers conducted a 5-min class based on various catchphrases once per week using teaching materials developed for this study ("Healthy Living Sleep Guidelines for High School Students"). Twelve classes were conducted. The baseline and follow-up surveys were performed. The difference between the groups was examined using an intention-to-treat principle with the full analysis set. We selected the generalized estimating equation for this analysis. The intention-to-treat analysis revealed that the intervention group presented significantly greater prevention of insomnia symptoms and short sleep duration (< 6 h) compared to the control group (adjusted odds ratio: 0.72 [95% confidence interval: 0.54-0.96], adjusted odds ratio 0.79 [95% CI 0.67-0.94]). However, there were no significant differences in odds ratios between the two groups for poor subjective sleep quality, excessive daytime sleepiness, and late bedtime.This sleep hygiene education program may be useful as a low-cost, highly valid, and accessible primary prevention method for insomnia symptoms. However, the applicability of this program for children of other ages and regions needs to be verified.