Transdiagnostic Sleep and Circadian Intervention in Youth: Long-Term Follow-Up of a Randomized Controlled Trial

Objective This preregistered study compared the effects of the Transdiagnostic Sleep and Circadian Intervention (TranS-C) to Psychoeducation about sleep, health, yoga, meditation, and outdoor appreciation activities (PE) on sleep and circadian functioning, health risk, and sleep-health behaviors, at long-term follow-up (LTFU), an average of 8 years following treatment. We also examined if more sleep-health behaviors at LTFU were associated with better sleep and circadian functioning at LTFU and if better sleep and circadian functioning were associated with lower health risk at LTFU. Method At baseline, we randomized adolescents with an eveningness chronotype to TranS-C (n=89) or PE (n=87). Of this sample, we assessed 106 young adults (mean age at follow-up=22.5 years; n=55 from TranS-C; n=51 from PE) an average of eight years following treatment. Results Despite TranS-C (vs. PE) sustaining improvement in circadian functioning through 12-month follow-up, at LTFU, there were no significant differences between the conditions on any outcome—including sleep and circadian functioning, risks in five health domains indexed by self-report and ecological momentary assessment, sleep-health behaviors, and physical measurements. Across both conditions, measures indicating poorer sleep and circadian functioning were associated with higher health risk across multiple domains, and more sleep-health behaviors were associated with lower levels of eveningness at LTFU. Conclusion The results provide an important window into the influence of development on long-term outcomes for youth and raise the possibility that interventions for youth could be enhanced with a focus on habit formation.