As part of our World Mental Health Day Blog Series, Lorna Caddick, Dr Giulia Gaggioni and Professor Heather Whalley share the aims and progress of the AMBIENT-teens sleep study.
Our Goal
To assess the feasibility of an innovative passive sleep monitor within an adolescent population. In order to optimally inform research decisions we are working alongside young people through young person advisory groups (YPAGs) to co-produce research materials. Our long term aim is to develop protocols and analysis approaches that facilitate the use of non-invasive sleep data collection methods, at scale, in future longitudinal adolescent cohort studies. These methods can be used to address questions such as how sleep patterns change over critical developmental windows and what reflects normal sleep behaviours. Given links with mood and mental health, this research will be of keen interest to those involved in studying connections between sleep, health and psychopathology.
What do we know already?
Sleep plays a fundamental role in the development of young people. However, population-based data indicates that ~50% of school-aged children and adolescents are chronically sleep deprived1. In youth, sleep disturbances and changes to circadian rhythms have been associated with disrupted wellbeing and impaired cognitive functioning, as well as changes in brain structure2,3. Sleep plays a pivotal role in maintaining healthy physical, social, cognitive, and emotional development over childhood and adolescence. Therefore, there is a critical need for fully tested tools that can collect high quality sleep data in young people, over longer durations with minimal interruption to daily living. This is particularly important because sleep is a fundamental and modifiable aspect of health behaviour.
Young Person Advisory Groups (YPAGs)
To best conduct the study in adolescents, ages 8-18, we want to engage young people to offer ideas and help develop study protocols. By integrating recommendations from these age groups we hope to reduce the view of research participation as a burden and encourage minimally invasive methods of data collection while supporting interests of the young people.
To date, we have held multiple sessions with a senior YPAG (aged 15-18) and junior YPAG (aged 8-12 and their caregivers). During these sessions we taught, with the help of experts, young people about chronotypes and how the radar-based sensors monitor sleep through measuring movement and the room environment. The research team provided an overview of the study, focussing on what would be expected of the young people (see diagram below). This was followed by question and answer sessions to gauge areas of concern or uncertainty about the study. Young people gave feedback verbally or anonymously online. This feedback has been integrated in study materials such as age-appropriate video instructions and the format of study tasks.
Overview of the Study
Informed consent obtained from young people (ages 16-18) and caregivers (for young people aged <16)
Online questionnaires about demographics, chronotypes, sleep patterns, puberty and mental wellbeing are completed at baseline to assess the feasibility of the study protocols in young people from diverse backgrounds. This anonymous data will also be used with the young people to compare subjective perceptions and objective measures of sleep.
4-8 weeks of sleep analysis including:
1. Participant sets up a passive sleep sensor (Somnofy) in their bedroom that requires no additional manual input after following ‘plug-in-and-play’ instructions
2. Two weeks of actigraphy data collection alongside a sleep diary to compare against the passive sleep device
3. Weekly check-ins with participants to share their summary sleep data and discuss any issues or feedback
Feedback questionnaires are completed online after the data collection period
Young people take part in a citizen scientist or product reviewer task in the format of their own choosing to answer their own question about sleep
They have the option of sharing their study experience via a YPAG video call
Young people will receive certificates of participation and small monetary incentives to thank them for their time and engagement.
What's next?
This study is a stepping stone towards accessible sleep research on a much larger scale. Since the methods described here require minimal set up and rely on remote data capture, they will be of great interest to those targeting a range of sample populations, young and old, from diverse backgrounds and different areas of clinical interest. Specifically in a younger generation, we hope that their substantial involvement in this study will promote open discussions around sleep and health. This work will be disseminated to a young audience to stress the importance of high quality sleep on positive physical and mental wellbeing.
Lorna Caddick
Research Fellow, Centre for Clinical Brain Sciences, University of Edinburgh
References
Kocevska D et al. Nat Hum Beh 5:1 5:113–122(2020). 2 Gregory A & Sadeh A J Child Psychol Psych Allied Disc 57:296–317(2016). 3 Cheng W et al. Mol Psych 26:3992–4003(2021).
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