The primary goals of this project are to examine the short and long-term effects of improving sleep as animportant component of treating anxiety disorders in youth. These goals build upon four lines of evidenceregarding sleep and emotion regulation in adolescence: 1) Developmental changes in sleep, circadian, andaffective systems at puberty create increased vulnerabilities for both sleep and emotional problems (andtheir interactions) in ways that lead to high rates of sleep difficulties in adolescence. 2) Youth withGeneralized Anxiety Disorder are particularly prone to sleep problems because of increased vigilance andinclinations to worry and ruminate at bedtime; 3) Sleep loss can interfere with affect regulation and distresstolerance, and thus, sleep difficulties create added burdens in the domains of affective and socialfunctioning. 4) Insomnia and chronic sleep disturbance are significant risk factors for the development ofdepression and other adverse health outcomes. Taken together, these four lines of evidence raisecompelling questions regarding the opportunities for early intervention to improve and enhance sleep inyouth with anxiety. Project 2 addresses these questions by: (a) assessing sleep changes during CBT foranxiety to examine whether sleep improvements may partially mediate some positive effects of CBT; (b)offering a six-week sleep intervention to those children who continue to show sleep difficulties after CBT (c)testing this sleep intervention by randomizing 2/3 to receive the multi-component sleep intervention and 1/3to receive a comparison supportive treatment; and (d) assessing whether improving sleep will furtherenhance affective, clinical, and social functioning. This project addresses a set of issues of considerableclinical relevance in treating anxiety disorders. It also examines early adolescence as a key time indevelopment for sleep intervention in ways that could inform a prevention strategy for depression. Moregenerally, this project addresses issues of great concern to public health and social policy regarding theconsequences of insufficient sleep in youth not only its effects on cognitive, emotional, behavioral, andacademic function, but also a broader range of health problems where sleep has been implicated, includingthe development of affective disorders, alcohol, nicotine, and other substance use, accidents, and obesityand metabolic syndrome.
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