Subtyping at-risk adolescents for predicting response toward insomnia prevention program

Area of Science:

• Adolescent Sleep Medicine
• Clinical Psychology
• Preventive Psychiatry

Background:

• Previous research indicates a brief cognitive-behavioral insomnia prevention program can reduce insomnia risk by 71% in at-risk adolescents.
• This study investigates differential responses to insomnia prevention within specific subgroups of at-risk adolescents.

Purpose of the Study:

• To evaluate the effectiveness of an insomnia prevention program across different subgroups of at-risk adolescents.
• To identify distinct psychological profiles among adolescents at risk for insomnia.

Main Methods:

• Latent class analysis (LCA) identified three adolescent subgroups based on baseline sleep, daytime, and mood profiles.
• Adolescents were randomized to a 4-week insomnia prevention program or a control group.
• Assessments occurred at baseline, 1 week, and 6/12 months post-intervention, using an intention-to-treat approach.

Main Results:

• LCA identified subgroups: (a) insomnia symptoms only, (b) symptoms with daytime sleepiness/mild anxiety, (c) symptoms with daytime sleepiness/mild anxiety/depression.
• Insomnia disorder incidence was significantly reduced in subgroup 3 (HR=0.37) and marginally in subgroup 2 (HR=0.14) compared to controls.
• Intervention reduced excessive daytime sleepiness and anxiety in subgroups 2 and 3.

Conclusions:

• At-risk adolescents can be categorized into subgroups based on psychological profiles, influencing their response to insomnia prevention.
• Findings highlight the necessity for personalized insomnia prevention through further phenotyping and subgrouping of at-risk adolescents.