Need for Adaptation of Cognitive Behavioral Therapy for Adolescents With Insomnia: Sarah Honaker, PhD; Maureen McQuillan, PhD


The duo from Indiana University School of Medicine provided perspective on the reasons for why cognitive behavioral therapy used for insomnia need to be adjusted in adolescents with the sleep disorder. [WATCH TIME: 3 minutes]

WATCH TIME: 3 minutes

"We know that adolescents tend to have their circadian phase with later melatonin secretion over the course of puberty. We also know that they accumulate sleep pressure more slowly during adolescence."

Cognitive behavioral therapy for insomnia (CBT-I) guides patients through a series of changes in sleep-related behaviors. The focus is on addressing the 3 factors that contribute to the persistence of insomnia: conditioned arousal, identifying and eliminating habits that were developed to improve sleep but have become ineffective, and reducing sleep-related worry and other sources of heightened arousal. It has become a first line treatment for adults; however, there are complications with its use in other age populations.

At the 2023 SLEEP Annual Meeting, held June 3-7, in Indianapolis, Indiana, a group of investigators presented the DREAM-IT study, a trial aimed at eliciting perspectives from teens, parents, and providers on the acceptability and feasibility of CBT-I for teens. Led by Sarah Honaker, PhD, and Maureen McQuillan, PhD, the study used anonymous polling to assess likelihood, barriers, parent involvement, and adaptations among teeners and parents, and amount of use, perceived importance, and adaptations, among providers who use CBT-I.

In the results, limiting screens after bedtime was considered more feasible than before bedtime, according to stakeholders. In addition, over 60% of teens were “not at all likely” to follow the stimulus control guideline of only using their bed for sleep. Furthermore, 65% of adolescents reported willingness to practice sleep restriction, with the adaptation of a 2-hour later weekend wake time. Honaker, an associate professor of pediatrics, and McQuillan, a psychologist and assistant professor, both at the Indiana University School of Medicine, sat down with NeurologyLive® at the meeting to discuss the reasons for why insomnia differs among adolescents, and the need to adjust CBT-I appropriately.

Click here for more coverage of SLEEP 2023.

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