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Impact of a behavioral intervention, delivered by pediatricians or psychologists, on sleep problems in children with ADHD: a cluster‐randomized, translational trial.
- Source :
- Journal of Child Psychology; Nov2019, Vol. 60 Issue 11, p1230-1241, 12p, 1 Diagram, 4 Charts
- Publication Year :
- 2019
-
Abstract
- Background: We have demonstrated the efficacy of a brief behavioral intervention for sleep in children with ADHD in a previous randomized controlled trial and now aim to examine whether this intervention is effective and cost‐effective when delivered by pediatricians or psychologists in community settings. Methods: Translational, cluster‐randomized trial of a behavioral intervention versus usual care from 19th January, 2015 to 30th June, 2017. Participants (n = 361) were children aged 5–13 years with ADHD and parent report of a moderate/severe sleep problem who met criteria for American Academy of Sleep Medicine criteria for chronic insomnia disorder, delayed sleep–wake phase disorder, or were experiencing sleep‐related anxiety. Participants were randomized at the level of the pediatrician (n = 61) to intervention (n = 183) or usual care (n = 178). Families in the intervention group received two consultations with a pediatrician or a psychologist covering sleep hygiene and tailored behavioral strategies. Results: In an intention‐to‐treat analysis, at 3 and 6 months respectively, the proportion of children with moderate to severe sleep problems was lower in the intervention (28.0%, 35.8%) compared with usual care group (55.4%, 60.1%; 3 month: risk ratio (RR): 0.51, 95% CI 0.37, 0.70, p < .001; 6 month: RR: 0.58; 95% CI 0.45, 0.76, p < .001). Intervention children had improvements across multiple Children's Sleep Habits Questionnaire subscales at 3 and 6 months. No benefits of the intervention were observed in other domains. Cost‐effectiveness of the intervention was AUD 13 per percentage point reduction in child sleep problem at 3 months. Conclusions: A low‐cost brief behavioral sleep intervention is effective in improving sleep problems when delivered by community clinicians. Greater sample comorbidity, lower intervention dose or insufficient clinician supervisions may have contributed to the lack benefits seen in our previous trial. [ABSTRACT FROM AUTHOR]
- Subjects :
- ANXIETY treatment
INSOMNIA treatment
SLEEP disorders treatment
SLEEP disorder diagnosis
ATTENTION-deficit hyperactivity disorder
BEHAVIOR therapy
CHILDREN'S health
CLUSTER analysis (Statistics)
COMMUNITY health services
CONFIDENCE intervals
COST effectiveness
ECONOMIC aspects of diseases
INTERNAL medicine
MEDICAL care
PSYCHOLOGISTS
QUESTIONNAIRES
SLEEP disorders
ADOLESCENT health
RANDOMIZED controlled trials
TREATMENT effectiveness
PARENT attitudes
SEVERITY of illness index
ODDS ratio
SLEEP hygiene
Subjects
Details
- Language :
- English
- ISSN :
- 00219630
- Volume :
- 60
- Issue :
- 11
- Database :
- Complementary Index
- Journal :
- Journal of Child Psychology
- Publication Type :
- Academic Journal
- Accession number :
- 139114140
- Full Text :
- https://doi.org/10.1111/jcpp.13083