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The impact of school-based sleep interventions

Today’s teenagers are generally sleeping less and less and this can be extremely detrimental to their physical and mental wellbeing. A recent article by Dr Serena Bauducco presents the results of a new sleep curriculum  trialed with 3622 12-14 year olds in Swedish secondary schools. The programme focused on sleep education, time management skills and strategies to regulate the potential impact of using technology at night. The results showed that sleep duration increased after completing the sleep curriculum, whilst it decreased in pupils who had not taken part. The paper suggests that universal sleep interventions in schools could be effective in improving the quality and quantity of teenagers’ sleep.

Summary

The article examines the limited success of existing sleep interventions, noting that many universal programmes have not shown significant changes in observable sleep behaviours and that a lack of long term follow ups mean that the impact has not been measured over a significant time period. Noting that successful sleep interventions rely on correct timing, relevant contexts and a focus on practical skills, Dr Bauducco designed a preventative programme aimed at younger teens, where poor sleep habits are less likely to have become habitual and parental involvement might be more easily accepted. 

The programme included two main components. The first was sleep education; teaching about the importance of sleep and good sleep practices, including caffeine consumption, bedtime routines, technology and social jetlag. The second focused on improving time management strategies, such as planning or timing activities and setting reminders, to help reduce stress and better prioritise both daytime and evening activities. It aimed to help teens take control of their technology use by discussing both its positives and negatives, and the possibility of agreeing on family rules around digital use. Teens had five sessions, which were scheduled as part of the school curriculum and included homework, which involved parents. 

At a one year follow up, the teens who participated in the programme were about two times less likely to be categorised as ‘borderline’ or ‘insufficient’ sleepers and had significantly increased sleep knowledge. No improvements were observed for sleep hygiene, perceived stress or technology use.

Contrary to expectations, there was actually a significant increase in ICT use at bedtime in the intervention group. One possible explanation is that teens on the programme became more aware of their bedtime behaviours and technology use and reported worse sleep hygiene at their follow up. It raises important questions about whether it is possible to achieve a mobile‐free bedtime or whether it is better to teach adolescents sleep‐friendly technology time.

Implications

‘An increase in sleep duration in the intervention group as compared to a large representative population not receiving the intervention suggests that promoting sleep health in youths is indeed possible’.

Implications for schools – Unlike some previous school-based sleep interventions, which have had minimal impact on sleep, even in the short term, the findings from this study are promising in terms of the potential benefits of universal school-based programmes.

Teenagers report that school stress is a large contributing factor to poor sleep and data supports this. Schools can help by providing young people with time management tips and developing strategies for completing homework and having a balanced life.

Implications for parents

Research shows that parents’ rules around bedtime and sleep are one of the most powerful protective factors for children’s sleep, even into the teenage years. As children become teens and start to assert their independence, rules around bedtime often relax. Dr Bauducco advises that parents should seek to keep regular bedtime routines and rules into adolescence to help teens to sleep enough, and aim to have no more than 90 minutes discrepancy between weekday and weekend sleep and wake times.

Teens want help! The teens involved in the project reported that their parents were not always aware of their bedtime technology use and felt that discussion and rules around this would benefit their sleep quality. It might be helpful to have the same rules for the whole family.

 

Resources Created from and Related to this Research

Dr Serena Bauducco, Post-doctoral researcher in the department of psychology at Örebro University in Sweden

Dr Bauducco earned her PhD in 2017 with a thesis entitled “Adolescents’ Sleep in a 24/7 Society: Epidemiology and Prevention”. Her research focuses on the factors that may exacerbate or improve adolescents’ sleep, the relationship between sleep and mental health, and the potential of school-based interventions to improve teenagers’ sleep health.

Link to Article