Childhood obesity represents a major threat to public health. Sleep disturbance represents a significant comorbidity for overweight and obese (OV/OB) youth [(ages 6-12)] potentially contributing to a variety of negative consequences (lower quality of life, metabolic abnormalities) and further weight gain in this vulnerable population. Lack of sleep may contribute to increased weight status via reduced physical activity caused by fatigue;increased food intake caused by more opportunity to eat;cognitive, behavioral or mood impairments;and changes in metabolism that impact appetite or allow the body to conserve energy. Behavioral sleep disorders are more common in OV/OB youth than in general pediatric populations, with approximately 2 out of 3 OV/OB youth having significant problematic sleep behaviors. Behavioral interventions to address behavioral sleep disorders in children are efficacious in improving sleep in very young children. Improving sleep in OV/OB youth may enhance weight outcomes as improved sleep can lead to changes in energy, mood, appetite, motivation, and cues to eat that can augment a behavioral weight management intervention. Unfortunately, no research to date has examined the efficacy of cognitive behavioral treatment for child sleep (CBTcs) to address [behavioral sleep disorders (inadequate sleep hygiene, insufficient sleep syndrome, and insomnia)] in school-aged youth, nor exclusively in OV/OB youth. Preliminary evidence from our team suggests CBTcs holds great promise to improve sleep outcomes in OV/OB youth. However, more methodologically rigorous evaluation that also includes preliminary evaluation of secondary outcomes that could impact long-term weight status outcomes is needed. Thus, as the logical next step in this line of research, we propose to conduct a randomized controlled trial (RCT) that evaluates the efficacy of brief CBTcs to improve sleep in an important high-risk population, OV/OB youth with behavioral sleep disorders. OV/OB youth [(ages 6-12)] with behavioral sleep disorders (n = 60) and their parent(s) will be randomly assigned to [8 sessions] of either CBTcs or an [Educational Control (EC). CBTcs will address behavioral sleep issues in children;EC will address sleep and dietary education and general coping strategies.] Child sleep (total wake time, total sleep time, bed/wake times), height, weight, physical activity, dietary intake, quality of life (QOL), fatigue, and daytime sleepiness will be assessed at baseline, post-treatment, and 3-month follow-up.

Public Health Relevance

The proposed study will fill critical gaps in the literature by evaluating the efficacy of a family based cognitive behavioral treatment for child sleep in overweight and obese youth with [behavioral sleep disorders (inadequate sleep hygiene, insufficient sleep syndrome, and insomnia).

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Exploratory/Developmental Grants (R21)
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Biobehavioral Mechanisms of Emotion, Stress and Health Study Section (MESH)
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Twery, Michael
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University of Florida
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Schools of Public Health
United States
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McCrae, Christina S; Curtis, Ashley F; Williams, Jacob M et al. (2018) Efficacy of brief behavioral treatment for insomnia in older adults: examination of sleep, mood, and cognitive outcomes. Sleep Med 51:153-166