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Research indicates that adolescents are at risk for insomnia, but are reluctant to seek help. Treatment of insomnia has been extensively examined in adults, but studies with adolescents are sparse. The purpose of this pilot study was to assess feasibility and efficacy of cognitive behavioral therapy for insomnia (CBT-i) for adolescents in both group and Internet settings. Twenty-six adolescents received 6 weekly sessions of CBT-i in a group (N = 13) or individual Internet setting (N = 13). Their sleep was measured with actigraphy, sleep logs, and questionnaires at baseline, posttreatment, and a 2-month follow up. For both treatments, results show a significant improvement, with medium to large effect sizes (ESs) of sleep onset latency, wake after sleep onset, and sleep efficiency. There was also a small ES increase of total sleep time in sleep log measures, but not in actigraphy measures. On questionnaires measuring symptoms of insomnia and chronic sleep reduction, significant improvements occurred either at posttreatment or at follow up. No differences were found between the groups. This study indicates CBT-i, either in group or in Internet formats, is an effective treatment for insomnia in adolescents. Further studies in a randomized controlled design are warranted.

This prospective quasi-experiment (N = 175; mean age = 15.14 years) investigates changes in adolescents' sleep from low-stress (regular school week) to high-stress times (exam week), and examines the (moderating) role of chronic sleep reduction, baseline stress, and gender. Sleep was monitored over three consecutive weeks using actigraphy. Adolescents' sleep was more fragmented during the high-stress time than during the low-stress time, meaning that individuals slept more restless during stressful times. However, sleep efficiency, total sleep time, and sleep onset latency remained stable throughout the three consecutive weeks. High chronic sleep reduction was related to later bedtimes, later sleep start times, later sleep end times, later getting up times, and more time spent in bed. Furthermore, low chronic sleep reduction and high baseline stress levels were related to more fragmented sleep during stressful times. This study shows that stressful times can have negative effects on adolescents' sleep fragmentation, especially for adolescents with low chronic sleep reduction or high baseline stress levels.