Previous research has shown that insufficient sleep at night and daytime sleepiness contributes to psychological distress, cognitive deficiencies and poor academic performance. The current study examines the effect of nighttime sleep extension on sleep, psychological health, academic performance and cognitive functioning in a sample of adolescents with complaints of daytime sleepiness and insufficient nighttime sleep.Participants were 56 adolescents (34 females) aged 14 - 18 (Mean age = 16.46). Participants were given daily sleep diaries and actiwatch during an initial interview. Sleepiness, psychological, academic and cognitive assessments were completed after one week of sleep data collection. The participants were randomly assigned to either extend their sleep for at least 60 minutes on three consecutive school nights or continue with their normal sleep schedule. After the sleep extension the same battery of tasks were completed. Baseline and post-intervention sleep, psychological, academic and cognitive data included daily sleep diaries, the Pediatric Daytime Sleepiness Scale (PDSS), State Trait Anxiety Scale - Short (STAI-S), AIMS reading comprehension and mathematic questions, digit span, verbal fluency, trail making and go/no go inhibition.Nineteen of those assigned to extend their sleep succeeded (M = 80.35 min.). Repeated measures ANOVAs were performed on sleep, psychological well being, academics and cognitive assessments to evaluate the sleep extension intervention. Interactions for the sleep variables found that Sleep Extenders decreased difficulty in waking in the morning and daytime sleepiness, increased time in bed, total sleep time and sleep efficiency more than Non-Sleep Extenders, (all p < .05). No differences were found for the STAI-S or the academic questions. All participants improved on the forward digit span (p < .05); however, t-tests showed that only the Sleep Extenders improved on the backward digit span (p < .05). All participants performed worse on the verbal fluency task, (p < .01). Everyone improved on trail making part A (p < .01), however, only Sleep Extenders improved on trail making part B, (p < .01).Even small increases in the duration of nighttime sleep can improve sleep variables, reduce daytime sleepiness, and produce improvement on measures of cognitive ability requiring mental control and flexibility in adolescents.

Background and Objective: Type 1 diabetes mellitus (T1DM) is one of the most common pediatric chronic illnesses. Youth with T1DM have been shown to be at risk for internalizing problems and obtaining insufficient sleep. An emerging body of literature has demonstrated the feasibility and potential benefit of increasing sleep duration as a strategy to improve psychological outcomes in nondiabetic school age populations. The current study seeks to investigate the relationship between sleep and internalizing symptoms and empirically examine the effect of a sleep extension intervention on internalizing symptoms in youth with T1DM. Methods: The sample consisted of 106 youth with T1DM (mean age = 13.5 ± 2.1 years) who were part of a larger study recruited over a three-year period. Participants were 52.8% male and 50.9% identified as non-white. The primary outcome measure was the Behavior Assessment System for Children, Second Edition (BASC-2), both parent and self-report. Other behavioral and sleep measures included actigraphy, sleep diary, the School Sleep Habits Survey (SSHS), Pediatric Symptoms Checklist (PSC), and the Child Sleep Habits Questionnaire (CSHQ). Participants were randomly assigned to either the Sleep Extension condition (n = 50), in which they were asked to extend their sleep duration, or the Fixed Sleep Duration condition (n = 56), in which they were asked to maintain the same amount of sleep as their baseline. Results: Average sleep durations varied across measures, with all values falling in the lower range or below national recommendations. More than a third (34.5%) of the sample had elevated scores for internalizing problems based on parent report, and 17.7% were elevated based on self-report. Pearson correlations indicated that parent reported sleep duration was negatively related to self-reported anxiety, r(106) = -0.237, p = 0.018, as well as parent-reported depression, r(106) = -0.218, p = 0.028, and emotional self-control, r(106) = -0.232, p = 0.018. No other measure of sleep duration was significantly correlated with internalizing symptoms. Secondary analyses of measures of sleep quality including sleep efficiency (SE), wake after sleep onset (WASO), and sleepiness, were significantly related to internalizing problems based on both parent and self-report (all p < 0.05), whereas more variability in sleep duration (CV) was related to higher self-reported depression, r(106) = 0.210, p = 0.033. Following the sleep intervention, participants in the Sleep Extension condition increased their average sleep duration by 26.71 minutes based on actigraphy, while participants in the Fixed Sleep duration decreased by 0.14 minutes from pre- to post-intervention. Participants in the Sleep Extension condition had significantly lower scores on the BASC-2 Internalizing Problems Composite than participants in the Fixed Sleep Duration condition following the intervention, after controlling for sex and baseline internalizing symptoms, F(1, 98) = 4.18, p = 0.044. On average, the Internalizing Problems Composite score of participants in the Sleep Extension condition decreased by almost half a standard deviation (4.65 ± 6.41 points), compared to a decrease of 2.31 ± 6.59 points for participants in the Fixed Sleep Duration condition. There were no significant effects for self-report. Conclusions: Youth with T1DM obtained insufficient sleep and experienced high rates of internalizing symptoms. The results also suggest that relations between sleep and internalizing symptoms exist; however, these associations may be more driven by other aspects of sleep rather than actual sleep loss, such as nighttime sleep disturbance, daytime sleepiness, and variability of the sleep schedule. The findings further indicated that a sleep extension intervention was effective in increasing sleep duration, as well as reducing parent-reported internalizing symptoms in a sample of children and adolescents with T1DM. This intervention has the potential to be utilized as a cost effective, and relatively easy to implement method for reducing internalizing symptoms in youth with T1DM.

Insufficient sleep duration and poor sleep quality can potentiate weight gain and obesity in adolescents. Furthermore, overweight and obese females are at unique risk for insufficient sleep and associated health complications. We examined self-reported sleep duration and self-reported adequacy of sleep duration as potential moderators of the relationship between eating behavior and several cognitive processes including hedonic hunger, executive dysfunction, and self-control. We used a multisystemic conceptual framework to highlight the pathways that may explain the relationship between sleep behaviors and the Healthy Eating Index (HEI). The study employed a cross-sectional design. Participants completed baseline measures of height and weight, self-control, executive functioning, hedonic hunger, and sleep functioning. Self-report of poor sleep adequacy directly influenced executive dysfunction which consequently explained a decrease in self-control functioning. Moreover, we evaluated whether sleep deprivation and extension influences caloric intake. We offer novel yet promising evidence that 9 hrs of sleep fostered greater self-control functioning which promoted intake of 484.69 fewer calories per day compared to sleep deprivation. Our study is well-positioned to improve understanding of individual cognitive subsystems and the mechanism that underlies the influence of sleep behavior on weight-related behaviors among overweight and obese females. Findings from this study have the potential to inform health interventions that promote healthy eating and sleep behaviors.