A Micro-Randomized Trial To Improve College Students’ Wake Time Regularity
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Date
2020-09-24
Authors
Latham, Melissa
Journal Title
Journal ISSN
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Publisher
University of Oregon
Abstract
Many college students experience irregular sleep patterns due to their unique schedule. These patterns confer risk for other sleep problems as well as mental health difficulties including mood disorders, physical aggression, and suicidal ideation. Current interventions to improve college students’ sleep are often created using Cognitive Behavioral Therapy for Insomnia components, although the components used are often not consistent. These interventions are also plagued by drop out, often by those that need the intervention the most.
The current study takes a step toward creating an intervention with fewer, simpler components that is more agreeable to college students due to its ease and delivery through a phone-based application. In order to achieve this, I use a micro-randomized trial design to assess the most effective timing and content for an intervention that reminds students of techniques to help increase the regularity of their wake up times. The aims of the study were 1) to determine the feasibility and acceptability of the intervention; 2) to determine the effect of the reminders on immediate use of sleep hygiene strategies and on subsequent wake time regularity; and 3) to determine whether proximal outcomes were related to variability in wake times at the end of the intervention. Participants completed a baseline week of sleep diaries, an online psychoeducation module about sleep regularity, and then entered the intervention phase, where they were randomized each day to receive a reminder. If they were randomized to receive one, the timing and content of that reminder were also randomized.
The results of this study indicate that participants were invested in completing our intervention and found it somewhat helpful. However, there was no effect of the reminders nor their timing or content on proximal outcomes. Lastly, there was no relationship between sleep hygiene use and wake time variability during the final week of the study. Although our results indicate that the intervention components were not effective, future iterations of the study are being planned to address several important limitations. The goal of the next iteration will be to assess the effect of these reminders without a number of unintended, confounding factors.
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Keywords
college, intervention, micro-randomized trial, regularity, sleep