title: An e-mail delivered CBT for sleep-health program for college students: effects on sleep quality and depression symptoms.
abstract: OBJECTIVE
  We examined the effects of a cognitive behavioral self-help program (Refresh) to improve sleep, on sleep quality and symptoms of depression among first-year college students.
  
  
  METHODS
  Students in one residence hall (n = 48) participated in Refresh and students in another residence hall (n = 53) participated in a program of equal length (Breathe) designed to improve mood and increase resilience to stress. Both programs were delivered by e-mail in 8 weekly PDF files. Of these, 19 Refresh program participants and 15 Breathe program participants reported poor sleep quality at baseline (scores ≥ 5 on the Pittsburgh Sleep Quality Index [PSQI]). Participants completed the PSQI and the Center for Epidemiological Studies-Depression Scale (CES-D) at baseline and post-intervention.
  
  
  RESULTS
  Among students with poor sleep (PSQI > 5) at baseline, participation in Refresh was associated with greater improvements in sleep quality and greater reduction in depressive symptoms than participation in Breathe. Among students with high sleep quality at baseline there was no difference in baseline to post-intervention changes in sleep (PSQI) or depressive symptom severity (CES-D).
  
  
  CONCLUSIONS
  A cognitive behavioral sleep improvement program delivered by e-mail may be a cost effective way for students with poor sleep quality to improve their sleep and reduce depressive symptoms. An important remaining question is whether improving sleep will also reduce risk for future depression.
authors.affiliation: Stanford University, Stanford, CA, USA.
authors.forename: Mickey
authors.initials: M
authors.lastname: Trockel
authors.forename: Rachel
authors.initials: R
authors.lastname: Manber
authors.forename: Vickie
authors.initials: V
authors.lastname: Chang
authors.forename: Alexandra
authors.initials: A
authors.lastname: Thurston
authors.forename: Craig Barr
authors.initials: CB
authors.lastname: Taylor
authors.forename: Craig Barr
authors.initials: CB
authors.lastname: Tailor
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000339:Affect; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy*; D034742:Electronic Mail; D005260:Female; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy*; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology / Q000628:therapy; D013334:Students / Q000523:psychology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult