Targeting Adolescent Insomnia to Lessen Overall Risk of Suicidal Behavior
Jeff Bridge
235 participants
Oct 20, 2022
INTERVENTIONAL
Conditions
Summary
This study will test the effectiveness of a sleep-related primary suicide prevention program entitled TAILOR (Targeting Adolescent Insomnia to Lessen Overall Risk of Suicidal Behavior), which includes specific behavior-change strategies for adolescents at risk of suicidal behavior who suffer from difficulties falling asleep, staying asleep, and/or insufficient sleep.
Eligibility
Inclusion Criteria4
- Nationwide Children's Hospital patients
- Between the ages of 11 years, 0 months, and 18 years, 11 months, inclusive at time of consent
- Endorse both recent (past 90 days) suicidal ideation and sleep problems (past 30 days)
- Resides with primary caregiver who has legal authority to consent to research participation
Exclusion Criteria14
- Suicide attempt in the past 3 months
- Diagnosis of Bipolar Disorder or Psychosis
- Having a change to an antipsychotic and/or mood stabilizer medication regimen within the last 2 months
- Snoring at least 3 nights per week that can be heard a room or two away, even without a cold or flu or during allergy season
- Gasping for air while sleeping, diagnosis of Obstructive Sleep Apnea, or turning blue within the past year
- Body Mass Index \> 40
- Daytime symptoms of Restless Leg Syndrome
- Diagnosis of Narcolepsy
- Diagnosis of Seizures or Epilepsy, or prescribed anticonvulsant medication, within the past 4 years
- Significant substance use in the past month
- Currently receiving sleep disorder services from a sleep clinic
- Inability to speak/read English adequately to understand and complete study consent and procedures
- No access to a telephone or internet-connecting device
- Sibling already in the study
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Interventions
The first TAILOR session will assess existing sleep problems from both the adolescent's and parent/legal guardian's perspectives, concluding with offering a CBT strategy to try. Session 2 will involve getting feedback from the family on that specific strategy and then offering additional CBT strategies. The remaining sessions will be devoted to refining the use of CBT strategies. MI will be integrated as the communication style throughout, including reflective listening, rolling with resistance, and showing deference to the family's ultimate decisions. The interventionist will also use the "elicit-provide-elicit" approach from MI. The interventionist will elicit the family's own ideas for improving the adolescent's sleep, ask for permission to provide his/her own suggestions, and then gauge the family's reactions to those suggestions, versus simply recommending a CBT strategy and problem-solving barriers to implementation.
The study clinician will conduct suicide risk screening and further assessment and safety planning where deemed necessary.
Locations(1)
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NCT05390918