Introduction Insufficient sleep is highly prevalent in adolescents and there is high comorbidity between insomnia and mental health.¹ Due to a lack of awareness, training and access to effective interventions, sleep issues are rarely addressed in clinical practice, including Child and Adolescent Mental Health Services (CAMHS).² The Strathclyde intervention to encourage good sleep health for teenagers (SIESTA) was developed as a school-based programme featuring Cognitive Behavioural Therapy for insomnia (CBT-I) techniques. An initial feasibility study found that it was feasible, acceptable and effective for improving insomnia and stress.³ However, SIESTA was designed for delivery to all adolescents, irrespective of the presence of sleep difficulties, therefore, some evidence-based CBT-I techniques were excluded. Therefore, this study aimed to assess the appropriateness, and necessary adaptations required, to ensure SIESTA is suitable for delivery to adolescents attending CAMHS.

Methods This study utilised a Delphi technique to examine expert judgement on the appropriateness of SIESTA for the target population, method of delivery and intervention content. Two rounds of questionnaires were disseminated questions about the target population, content and delivery. The data was analysed using Thematic Analysis, descriptive and frequency statistics (table 1).

Results Three main themes were identified in round one including: SIESTA is appropriate for adolescents with anxiety and depression, content and design is appropriate but may require adaptation, session format is suitable and parent/caregiver involvement is necessary for implementation. Round two confirmed that a four-session format should be included featuring sleep restriction therapy and stimulus control. The third and final round is currently ongoing to approve the final materials.

Discussion To our knowledge, this is the first study to utilise the Delphi technique to adapt a sleep intervention. The findings from this study have been used to inform the development of SIESTA for this new population and context.

References

1. de Bruin EJ, Bögels SM, Oort FJ, Meijer AM. Efficacy of cognitive behavioral therapy for insomnia in adolescents: a randomized controlled trial with internet therapy, group therapy and a waiting list condition. Sleep, 2015;38(12):1913–1926.

2. Higson-Sweeney N, Loades ME, Hiller R, et al. Addressing sleep problems and fatigue within child and adolescent mental health services: A qualitative study. Clinical Child Psychology and Psychiatry 2020;25(1). SAGE Publications Ltd: 200–212.

3. McCrory S, Crawford M, Fleming L. Evaluating the feasibility of delivering a sleep education programme in secondary schools. Health Education Journal, 2023:00178969231152960.