Blended CBT sleep intervention to improve sleep, ADHD symptoms and related problems in adolescents with ADHD (CBT)

ADHD is highly prevalent, in adolescence daily life problems and comorbidity steeply increase. Up to 75% of the adolescents experience sleep problems casually related to increased ADHD symptom impairment, oppositional, depressive symptomatology and functional impairments. Most common sleep difficulties are insomnia, daytime sleepiness, nocturnal awakenings and nonrestorative sleep, often accompanied by inadequate sleep hygiene and/or spending too little time in bed. Sleep problems become more prevalent over the life-span. Thus, reducing sleep problems is an important intervention target. However, there is no evidence based cognitive behavioral sleep treatment available for adolescents with ADHD, although in school-aged children with ADHD parent-mediated behavioral sleep treatments are effective. Sleep problems in adolescents with ADHD may have received little attention because of the difficulty of providing treatment for them; they have severe problems with organization, resisting immediate temptations, and are noted for treatment drop-out and non-compliance and parent-mediated interventions generally don ’t work, making regular non-ADHD specific CBT programs bound not to work. Sleep-focused treatments need adaptation towards this developmental phase/disorder for effectiveness, as ADHD and sleep problems are bi-directional. Therefore a blended treatment targeting these core deficits integrating motivational interviewing, planning skills and sleep interventions is needed. Project aims are 1) A pilot study of the blended intervention to fine-tune the manual 2) Testing the effectiveness of the blended CBT sleep intervention in adolescents with ADHD. The intervention is expected to reduce sleep-problems, ADHD, internalizing and externalizing symptoms and daily life impairments. 3) When effective, widely implementing this treatment across (mental) health care and facilitating treatment access for all parties involved.