Investigating a sleep intervention for adolescents attending CAMHS
Research type
Research Study
Full title
Investigating the feasibility, acceptability, and preliminary effectiveness of a sleep intervention for adolescents with co-morbid insomnia and mental health difficulties.
IRAS ID
322251
Contact name
Stephanie McCrory
Contact email
Sponsor organisation
University of Strathclyde
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 6 months, 31 days
Research summary
Summary of Research
Sleep problems have a significant detrimental impact on physical health, development, and functioning and are commonly experienced co-morbidly with other mental health problems. Therefore, many adolescents who are attending Child and Adolescent Mental Health Services (CAMHS), also experience significant sleep disturbances. However, sleep problems are rarely addressed within CAMHS due to lack of awareness of the importance of sleep and/or training in effective treatments. Cognitive behavioural therapy for insomnia (CBT-I) is the recommended approach for treating insomnia in both adult and adolescent populations. Despite this, there has been limited research investigating the delivery of CBT-I interventions to adolescents attending CAMHS, and to our knowledge, no such studies exist within the Scottish context. The Strathclyde intervention to encourage good sleep health for teenagers (SIESTA) is a CBT-I intervention to improve adolescent sleep. This study aims to evaluate the feasibility, acceptability, and preliminary effectiveness of SIESTA for adolescents attending CAMHS. Staff within CAMHS will receive training to deliver SIESTA to groups of adolescents with co-morbid mental health and sleep problems. The following feasibility benchmarks will be assessed: recruitment and retention, participant attendance, facilitator training, intervention fidelity and participant adherence. Acceptability will be measured via qualitative interviews with participants and CAMHS staff. Baseline, post-intervention, and follow-up assessments will be conducted to assess preliminary effectiveness of the intervention for improving sleep and mental health. This research is necessary to inform future trials of SIESTA and to support its wider implementation within CAMHS.Summary of Results
We successfully recruited and trained 6 practitioners from CAMHS to deliver the intervention and recruit adolescent participants. In total, 4 referrals were received from CAMHS and 1 participant provided consent. However, the participant completed the baseline assessment, attended 3 sessions and did not complete the post-intervention assessment.
We had significant challenges with recruitment for this study. We worked closely with staff in the service to try overcome these challenges. However, the main barrier to recruitment was that most adolescents with insomnia in the service 1) had a diagnosis of a neurodevelopmental disorder, or 2) were experiencing suicidal ideation, both of which were part of the exclusion criteria. The exclusion criteria was based on the findings of a Delphi study and in collaboration with representatives from the CAMHS team. Therefore, it was not appropriate to amend the criteria.
Following this, 8 staff were interviewed to explore barriers and facilitators of implementing the intervention in CAMHS. The main themes identified were: 1) sleep problems are common in adolescents attending mental health services, but they are poorly assessed and treated, 2) the training workshops and CBTi intervention was acceptable for practitioners in mental health services, 3) the CBTi intervention may not be suitable for most adolescents attending mental health services in Scotland, 4) CBTi must be delivered flexibly, balancing patient need and available resource, 5) Conducting research in mental health services was challenging.
This research has provided valuable learning into the implementation of CBTi interventions in mental health services and conducting research in real-world settings. A summary of the findings will be shared with the service and participants.REC name
West of Scotland REC 1
REC reference
23/WS/0083
Date of REC Opinion
21 Jul 2023
REC opinion
Further Information Favourable Opinion