title: Multicomponent cognitive-behavioural intervention to improve sleep in adolescents: a multiple baseline design.
abstract: BACKGROUND
  Adolescents are prone to sleep problems that have unique developmental aspects and contribute to physical, emotional, and behavioural problems.
  
  
  OBJECTIVE
  This study evaluated an individualized, multicomponent intervention that considered developmental factors, and promoted age-appropriate autonomy in three adolescent females with disrupted sleep.
  
  
  METHODS
  Adolescents recorded sleep data on daily logs. A nonconcurrent multiple baseline design was used to evaluate a cognitive-behavioural intervention including sleep hygiene training, bedtime routine development, cognitive restructuring, relaxation training, stimulus control, sleep restriction, bedtime fading, and problem-solving, along with clinically indicated individualization.
  
  
  RESULTS
  Outcomes demonstrated clinically meaningful improvements and decreased variability in sleep parameters following intervention. Each participant's sleep log data indicated improvement in, or maintenance of, adequate total sleep time (TST), decreased sleep onset latency (SOL), improved sleep efficiency (SE), improvement in time of sleep onset, and decreased or continued low frequency of night awakenings (NA). Anecdotally, adolescents and parents reported improvement in daytime functioning, coping, and sense of wellbeing.
  
  
  CONCLUSIONS
  These cases highlight the potential for cognitive-behavioural interventions to facilitate healthy sleep in adolescents with challenging sleep problems.
authors.affiliation: Kennedy Krieger Institute, and Johns Hopkins University School of Medicine, Baltimore, USA.
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Hendricks
authors.affiliation: Kennedy Krieger Institute, and Johns Hopkins University School of Medicine, Baltimore, USA.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Ward
authors.affiliation: Kennedy Krieger Institute, and Johns Hopkins University School of Medicine, Baltimore, USA.
authors.forename: Lauren K
authors.initials: LK
authors.lastname: Grodin
authors.affiliation: Kennedy Krieger Institute, and Johns Hopkins University School of Medicine, Baltimore, USA.
authors.forename: Keith J
authors.initials: KJ
authors.lastname: Slifer
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy / Q000379:methods; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods* / Q000523:psychology; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D026684:Personal Autonomy; D012064:Relaxation Therapy; D012892:Sleep Deprivation / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*