[article]
Titre : |
Impact of a behavioral intervention, delivered by pediatricians or psychologists, on sleep problems in children with ADHD: a cluster-randomized, translational trial |
Type de document : |
Texte imprimé et/ou numérique |
Auteurs : |
H. HISCOCK, Auteur ; M. MULRANEY, Auteur ; H. HEUSSLER, Auteur ; Nicole J. RINEHART, Auteur ; T. SCHUSTER, Auteur ; A. C. GROBLER, Auteur ; L. GOLD, Auteur ; S. BOHINGAMU MUDIYANSELAGE, Auteur ; N. HAYES, Auteur ; E. SCIBERRAS, Auteur |
Article en page(s) : |
p.1230-1241 |
Langues : |
Anglais (eng) |
Mots-clés : |
Sleep attention-deficit/hyperactivity disorder effectiveness randomized controlled trial |
Index. décimale : |
PER Périodiques |
Résumé : |
BACKGROUND: We have demonstrated the efficacy of a brief behavioral intervention for sleep in children with ADHD in a previous randomized controlled trial and now aim to examine whether this intervention is effective and cost-effective when delivered by pediatricians or psychologists in community settings. METHODS: Translational, cluster-randomized trial of a behavioral intervention versus usual care from 19th January, 2015 to 30th June, 2017. Participants (n = 361) were children aged 5-13 years with ADHD and parent report of a moderate/severe sleep problem who met criteria for American Academy of Sleep Medicine criteria for chronic insomnia disorder, delayed sleep-wake phase disorder, or were experiencing sleep-related anxiety. Participants were randomized at the level of the pediatrician (n = 61) to intervention (n = 183) or usual care (n = 178). Families in the intervention group received two consultations with a pediatrician or a psychologist covering sleep hygiene and tailored behavioral strategies. RESULTS: In an intention-to-treat analysis, at 3 and 6 months respectively, the proportion of children with moderate to severe sleep problems was lower in the intervention (28.0%, 35.8%) compared with usual care group (55.4%, 60.1%; 3 month: risk ratio (RR): 0.51, 95% CI 0.37, 0.70, p < .001; 6 month: RR: 0.58; 95% CI 0.45, 0.76, p < .001). Intervention children had improvements across multiple Children's Sleep Habits Questionnaire subscales at 3 and 6 months. No benefits of the intervention were observed in other domains. Cost-effectiveness of the intervention was AUD 13 per percentage point reduction in child sleep problem at 3 months. CONCLUSIONS: A low-cost brief behavioral sleep intervention is effective in improving sleep problems when delivered by community clinicians. Greater sample comorbidity, lower intervention dose or insufficient clinician supervisions may have contributed to the lack benefits seen in our previous trial. |
En ligne : |
http://dx.doi.org/10.1111/jcpp.13083 |
Permalink : |
https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=408 |
in Journal of Child Psychology and Psychiatry > 60-11 (November 2019) . - p.1230-1241
[article] Impact of a behavioral intervention, delivered by pediatricians or psychologists, on sleep problems in children with ADHD: a cluster-randomized, translational trial [Texte imprimé et/ou numérique] / H. HISCOCK, Auteur ; M. MULRANEY, Auteur ; H. HEUSSLER, Auteur ; Nicole J. RINEHART, Auteur ; T. SCHUSTER, Auteur ; A. C. GROBLER, Auteur ; L. GOLD, Auteur ; S. BOHINGAMU MUDIYANSELAGE, Auteur ; N. HAYES, Auteur ; E. SCIBERRAS, Auteur . - p.1230-1241. Langues : Anglais ( eng) in Journal of Child Psychology and Psychiatry > 60-11 (November 2019) . - p.1230-1241
Mots-clés : |
Sleep attention-deficit/hyperactivity disorder effectiveness randomized controlled trial |
Index. décimale : |
PER Périodiques |
Résumé : |
BACKGROUND: We have demonstrated the efficacy of a brief behavioral intervention for sleep in children with ADHD in a previous randomized controlled trial and now aim to examine whether this intervention is effective and cost-effective when delivered by pediatricians or psychologists in community settings. METHODS: Translational, cluster-randomized trial of a behavioral intervention versus usual care from 19th January, 2015 to 30th June, 2017. Participants (n = 361) were children aged 5-13 years with ADHD and parent report of a moderate/severe sleep problem who met criteria for American Academy of Sleep Medicine criteria for chronic insomnia disorder, delayed sleep-wake phase disorder, or were experiencing sleep-related anxiety. Participants were randomized at the level of the pediatrician (n = 61) to intervention (n = 183) or usual care (n = 178). Families in the intervention group received two consultations with a pediatrician or a psychologist covering sleep hygiene and tailored behavioral strategies. RESULTS: In an intention-to-treat analysis, at 3 and 6 months respectively, the proportion of children with moderate to severe sleep problems was lower in the intervention (28.0%, 35.8%) compared with usual care group (55.4%, 60.1%; 3 month: risk ratio (RR): 0.51, 95% CI 0.37, 0.70, p < .001; 6 month: RR: 0.58; 95% CI 0.45, 0.76, p < .001). Intervention children had improvements across multiple Children's Sleep Habits Questionnaire subscales at 3 and 6 months. No benefits of the intervention were observed in other domains. Cost-effectiveness of the intervention was AUD 13 per percentage point reduction in child sleep problem at 3 months. CONCLUSIONS: A low-cost brief behavioral sleep intervention is effective in improving sleep problems when delivered by community clinicians. Greater sample comorbidity, lower intervention dose or insufficient clinician supervisions may have contributed to the lack benefits seen in our previous trial. |
En ligne : |
http://dx.doi.org/10.1111/jcpp.13083 |
Permalink : |
https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=408 |
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