The role of the transdiagnostic sleep and circadian intervention in adolescent bedtime and sleep quality: a pilot study.

purposeCircadian misalignment is prevalent among adolescents and contributes to sleep deficiency and mental health struggles. There is a need for interventions targeting sleep and circadian difficulties in adolescents. This pilot study examined the effectiveness of a Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TSC) in a community-based adolescent sample with circadian misalignment. We hypothesized that TSC would improve sleep timing and duration, lessen circadian misalignment, improve subjective sleep quality, shorten sleep onset latency, and improve mental health outcomes.

methodsThirty-one adolescents (M age = 15.9 years (SD = 1.3); 45.2% female; 67.7% White) with self-reported circadian misalignment completed the six-week TSC intervention. Using a within-subject design, outcomes were assessed via actigraphy, dim-light melatonin onset (DLMO), Morningness-Evening Questionnaire, Pittsburgh Sleep Quality Index, and Depression Anxiety and Stress Scale-21 Item before and after the intervention. Repeated-measure Generalized Linear Models were conducted to examine differences across outcomes from pre- to post-intervention.

resultsTSC was associated with a significant earlier shift in sleep midpoint (~ 30 min; p = .023, g = .591) and weekend sleep onset (p = .003, g = .856), alongside improved subjective sleep quality (p = .021, g = .452). No significant changes were observed in DLMO, circadian misalignment index, total sleep duration, sleep onset latency, chronotype, or any mental health outcomes.

conclusionTSC demonstrated improvements in behavioral sleep timing and perceived sleep quality in a community-based adolescent sample, even without detectable biological circadian phase shifts. These findings extend prior efficacy research into real-world clinical contexts. Future studies should incorporate control groups, longer follow-up periods, and more diverse samples to clarify TSC's mechanisms and broader effectiveness. CURRENT KNOWLEDGE/STUDY RATIONALE: Circadian misalignment is prevalent among adolescents and contributes to sleep deficiency and mental health struggles, highlighting a need for effective interventions targeting sleep and circadian difficulties in adolescents. The Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TSC) is a promising intervention, but more research is needed to fully understand its effectiveness across multiple contexts. STUDY IMPACT: This pilot study investigated the effectiveness of TSC on the sleep, circadian functioning, and mental health of adolescents with circadian misalignment. Our results increase our understanding of the strengths and limitations of TSC, which informs future research and clinical practice.