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A shared-management web-based intervention for sleep deficiency in school-age children with juvenile idiopathic
Shumenghui Zhai1, Tonya M Palermo2,3, Susan Shenoi4,5
1School of Nursing, Pacific Lutheran University, Seattle, Washington.
Insights
The SLEEPSMART intervention improved sleep quality and self-efficacy in children with juvenile idiopathic arthritis. This pilot study demonstrated the intervention
Area of Science:
- Pediatric Rheumatology
- Sleep Medicine
- Behavioral Health
Background:
- Juvenile idiopathic arthritis (JIA) is associated with sleep disturbances.
- Effective sleep interventions are needed for children with JIA and their families.
- A pilot study evaluated the SLEEPSMART intervention for JIA-related sleep deficiency.
Purpose of the Study:
- To assess the feasibility and acceptability of the SLEEPSMART intervention.
- To determine the preliminary efficacy of SLEEPSMART on sleep outcomes in children with JIA.
- To evaluate the intervention's impact on parental sleep and self-efficacy.
Main Methods:
- A randomized controlled trial involving 50 children (8-13 years) with JIA and sleep deficiency.
- Participants were randomized to the 7-week SLEEPSMART intervention or usual care.
- Sleep was assessed using actigraphy, sleep diaries, and validated surveys.
Main Results:
- The SLEEPSMART intervention was feasible and acceptable to child-parent dyads.
- Children in the SLEEPSMART group showed significant improvements in total sleep time and sleep efficiency.
- Both children and parents reported reduced sleep disturbances and improved self-efficacy.
Conclusions:
- The SLEEPSMART intervention is a feasible and acceptable approach for improving sleep in children with JIA.
- The intervention demonstrates preliminary efficacy in enhancing objective and subjective sleep measures.
- SLEEPSMART shows promise for improving sleep health and self-efficacy in pediatric rheumatology populations.
Study Objectives:
We aimed to describe the feasibility, acceptability, and preliminary efficacy of a pilot randomized controlled trial of a sleep health intervention (SLEEPSMART) for children with juvenile idiopathic arthritis and their parents.
Methods:
Fifty children, 8-13 years of age, with juvenile idiopathic arthritis and sleep deficiency and their parents participated in the study. Participants were randomized to either the SLEEPSMART intervention or the control group (usual care). The SLEEPSMART intervention lasted 7 weeks and included weekly educational modules, quizzes, assignments, goal setting, and an online sleep coach. Children wore actigraphy and completed sleep diaries and surveys at baseline, immediately postintervention, and 1 month postintervention. Feasibility was measured by the percentage of eligible, enrolled, and retained child-parent dyads; engagement was measured when dyads completed the modules; and usefulness and acceptability were measured with the Treatment Evaluation Inventory and qualitative exit interviews.
Results:
Of the 50 child-parent dyads enrolled, 88% completed the baseline assessment. Seventy-five percent of children and 89% of parents reported high acceptance; 89% of parents and 80% of children recommend SLEEPSMART. Compared to children in the control group, those who received the SLEEPSMART intervention had significant improvements in actigraphy total sleep time and sleep efficiency and Patient-Reported Outcomes Measurement Information System sleep disturbance scores immediately postintervention and at 1-month follow-up and in their dysfunctional beliefs and attitudes about sleep and sleep efficacy scores 1 month postintervention. Parents in the SLEEPSMART group had significant improvements in the Patient-Reported Outcomes Measurement Information System sleep-related impairment and dysfunctional beliefs and attitudes about sleep scores immediately postintervention and at 1-month follow-up and in their self-efficacy scores 1 month postintervention in comparison to parents in the control group.
Conclusions:
SLEEPSMART was feasible, acceptable, and improved objective and self-report sleep and self-efficacy outcomes in children with juvenile idiopathic arthritis and their parents.
Clinical Trial Registration:
Registry: ClinicalTrials.gov; Name: Sleep Shared-Management Intervention for Children with Juvenile Idiopathic Arthritis; URL: https://clinicaltrials.gov/study/NCT04066205; Identifier: NCT04066205.
Citation:
Zhai S, Palermo TM, Shenoi S, et al. A shared-management web-based intervention for sleep deficiency in school-age children with juvenile idiopathic arthritis and their parents: feasibility and acceptability study. J Clin Sleep Med. 2025;21(6):1007-1021.
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