A pilot randomised control study to investigate the effect of the South African Adolescence Group Sleep Intervention (SAASI) on adolescent sleep and PTSD

Jaco Rossouw; Sharain Suliman; Jani Nothling; Carl Lombard; Erine Bröcker; Maryke Hewett; Candice Simmons; Gillian W. Shorter; Soraya Seedat; Melissa E. Milanak; Cherie Armour

doi:10.1080/20008066.2024.2350217

A pilot randomised control study to investigate the effect of the South African Adolescence Group Sleep Intervention (SAASI) on adolescent sleep and PTSD

Jaco Rossouw^*, Sharain Suliman, Jani Nothling, Carl Lombard, Erine Bröcker, Maryke Hewett, Candice Simmons, Gillian W. Shorter, Soraya Seedat, Melissa E. Milanak, Cherie Armour

^*Corresponding author for this work

School of Psychology

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Abstract

Background: Trauma exposure prevalence and consequent post-traumatic stress disorder among South African adolescents are significant. Sleep disturbances are among the most frequently reported difficulties faced by those dealing with PTSD. The current study examined the feasibility and preliminary efficacy of the South African Adolescence Group Sleep Intervention on PTSD symptom severity and sleep disturbance.

Method: Sixty-one adolescents with PTSD diagnoses and sleep disturbance were randomly assigned (1:1) to one individual and four group sessions of a sleep intervention (SAASI) or a control group. Participants completed the Child PTSD symptom scale for DSM5 (CPSS-5) and the Pittsburgh Sleep Quality Index (PSQI) among other sleep and psychiatric measures. The trial was registered on the Pan African Trial Registry (PACTR202208559723690).

Results: There was a significant but similar decrease in PSQI scores in both groups over time indicating no overall intervention effect (Wald test = −2.18, p = .029), mean slope = −0.2 (95% CI: −0.37 to −0.02) (p = .583). On the CPSS-5, interaction between groups was also not significant (p = .291). Despite this overall finding, the mean difference in CPSS-SR-5 scores increased over time, with the difference between groups post-treatment -9.10 (95%CI: −18.00 to −0.21), p = .045 and the 1-month follow-up contrast - 11.22 (95%CI: −22.43 to −0.03), p = .049 suggesting that PTSD symptom severity decreased more in the intervention group than the control group. The dropout rate was higher than expected for both the intervention (n = 10; 32%) and control (n = 8; 26.7%) groups. Dropout were mostly school commitments or travel related.

Conclusions: Early findings suggest a trend towards dual improvement in sleep quality and PTSD symptom severity in adolescents with a sleep disturbance and PTSD receiving a group sleep intervention (SAASI). Further investigation in a properly powered RCT with detailed retention planning is indicated.

Original language	English
Article number	2350217
Number of pages	14
Journal	European Journal of Psychotraumatology
Volume	15
Issue number	1
DOIs	https://doi.org/10.1080/20008066.2024.2350217
Publication status	Published - 22 May 2024

Keywords

PTSD severity
sleep disturbance
adolescents
sleep intervention
task-shifting
brief intervention
group interveniton
sleep quality
Trastornos Del Sueño
Stress Disorders, Post-Traumatic
Calidad De Sueño
Humans
Male
Ptsd Severity
Gravedad Del Tept
Intervención Del Sueño
Group Intervention
Female
Psychotherapy, Group
Adolescents
Brief Intervention
Cambio De Tareas
Sleep Disturbance
Sleep Wake Disorders
Intervención Breve
Pilot Projects
Sleep Intervention
Sleep
Sleep Quality
Adolescent
Intervención Grupal
Adolescentes
South Africa
Task-shifting

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1080/20008066.2024.2350217Licence: CC BY-NC

A pilot randomised control study to investigate the effect of the South African Adolescence Group Sleep Intervention (SAASI) on adolescent sleep and PTSD
Copyright 2024 The Authors. This is an open access Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits use, distribution and reproduction for non-commercial purposes, provided the author and source are cited.
Final published version, 1.2 MBLicence: CC BY-NC

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Rossouw, J., Suliman, S., Nothling, J., Lombard, C., Bröcker, E., Hewett, M., Simmons, C., Shorter, G. W., Seedat, S., Milanak, M. E., & Armour, C. (2024). A pilot randomised control study to investigate the effect of the South African Adolescence Group Sleep Intervention (SAASI) on adolescent sleep and PTSD. European Journal of Psychotraumatology, 15(1), Article 2350217. https://doi.org/10.1080/20008066.2024.2350217

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title = "A pilot randomised control study to investigate the effect of the South African Adolescence Group Sleep Intervention (SAASI) on adolescent sleep and PTSD",

abstract = "Background: Trauma exposure prevalence and consequent post-traumatic stress disorder among South African adolescents are significant. Sleep disturbances are among the most frequently reported difficulties faced by those dealing with PTSD. The current study examined the feasibility and preliminary efficacy of the South African Adolescence Group Sleep Intervention on PTSD symptom severity and sleep disturbance.Method: Sixty-one adolescents with PTSD diagnoses and sleep disturbance were randomly assigned (1:1) to one individual and four group sessions of a sleep intervention (SAASI) or a control group. Participants completed the Child PTSD symptom scale for DSM5 (CPSS-5) and the Pittsburgh Sleep Quality Index (PSQI) among other sleep and psychiatric measures. The trial was registered on the Pan African Trial Registry (PACTR202208559723690).Results: There was a significant but similar decrease in PSQI scores in both groups over time indicating no overall intervention effect (Wald test = −2.18, p = .029), mean slope = −0.2 (95% CI: −0.37 to −0.02) (p = .583). On the CPSS-5, interaction between groups was also not significant (p = .291). Despite this overall finding, the mean difference in CPSS-SR-5 scores increased over time, with the difference between groups post-treatment -9.10 (95%CI: −18.00 to −0.21), p = .045 and the 1-month follow-up contrast - 11.22 (95%CI: −22.43 to −0.03), p = .049 suggesting that PTSD symptom severity decreased more in the intervention group than the control group. The dropout rate was higher than expected for both the intervention (n = 10; 32%) and control (n = 8; 26.7%) groups. Dropout were mostly school commitments or travel related.Conclusions: Early findings suggest a trend towards dual improvement in sleep quality and PTSD symptom severity in adolescents with a sleep disturbance and PTSD receiving a group sleep intervention (SAASI). Further investigation in a properly powered RCT with detailed retention planning is indicated.",

keywords = "PTSD severity, sleep disturbance, adolescents, sleep intervention, task-shifting, brief intervention, group interveniton, sleep quality, Trastornos Del Sue{\~n}o, Stress Disorders, Post-Traumatic, Calidad De Sue{\~n}o, Humans, Male, Ptsd Severity, Gravedad Del Tept, Intervenci{\'o}n Del Sue{\~n}o, Group Intervention, Female, Psychotherapy, Group, Adolescents, Brief Intervention, Cambio De Tareas, Sleep Disturbance, Sleep Wake Disorders, Intervenci{\'o}n Breve, Pilot Projects, Sleep Intervention, Sleep, Sleep Quality, Adolescent, Intervenci{\'o}n Grupal, Adolescentes, South Africa, Task-shifting",

author = "Jaco Rossouw and Sharain Suliman and Jani Nothling and Carl Lombard and Erine Br{\"o}cker and Maryke Hewett and Candice Simmons and Shorter, {Gillian W.} and Soraya Seedat and Milanak, {Melissa E.} and Cherie Armour",

year = "2024",

month = may,

day = "22",

doi = "10.1080/20008066.2024.2350217",

language = "English",

volume = "15",

journal = "European Journal of Psychotraumatology",

issn = "2000-8066",

publisher = "Co-Action Publishing",

number = "1",

}

Rossouw, J, Suliman, S, Nothling, J, Lombard, C, Bröcker, E, Hewett, M, Simmons, C, Shorter, GW, Seedat, S, Milanak, ME & Armour, C 2024, 'A pilot randomised control study to investigate the effect of the South African Adolescence Group Sleep Intervention (SAASI) on adolescent sleep and PTSD', European Journal of Psychotraumatology, vol. 15, no. 1, 2350217. https://doi.org/10.1080/20008066.2024.2350217

TY - JOUR

T1 - A pilot randomised control study to investigate the effect of the South African Adolescence Group Sleep Intervention (SAASI) on adolescent sleep and PTSD

AU - Rossouw, Jaco

AU - Suliman, Sharain

AU - Nothling, Jani

AU - Lombard, Carl

AU - Bröcker, Erine

AU - Hewett, Maryke

AU - Simmons, Candice

AU - Shorter, Gillian W.

AU - Seedat, Soraya

AU - Milanak, Melissa E.

AU - Armour, Cherie

PY - 2024/5/22

Y1 - 2024/5/22

N2 - Background: Trauma exposure prevalence and consequent post-traumatic stress disorder among South African adolescents are significant. Sleep disturbances are among the most frequently reported difficulties faced by those dealing with PTSD. The current study examined the feasibility and preliminary efficacy of the South African Adolescence Group Sleep Intervention on PTSD symptom severity and sleep disturbance.Method: Sixty-one adolescents with PTSD diagnoses and sleep disturbance were randomly assigned (1:1) to one individual and four group sessions of a sleep intervention (SAASI) or a control group. Participants completed the Child PTSD symptom scale for DSM5 (CPSS-5) and the Pittsburgh Sleep Quality Index (PSQI) among other sleep and psychiatric measures. The trial was registered on the Pan African Trial Registry (PACTR202208559723690).Results: There was a significant but similar decrease in PSQI scores in both groups over time indicating no overall intervention effect (Wald test = −2.18, p = .029), mean slope = −0.2 (95% CI: −0.37 to −0.02) (p = .583). On the CPSS-5, interaction between groups was also not significant (p = .291). Despite this overall finding, the mean difference in CPSS-SR-5 scores increased over time, with the difference between groups post-treatment -9.10 (95%CI: −18.00 to −0.21), p = .045 and the 1-month follow-up contrast - 11.22 (95%CI: −22.43 to −0.03), p = .049 suggesting that PTSD symptom severity decreased more in the intervention group than the control group. The dropout rate was higher than expected for both the intervention (n = 10; 32%) and control (n = 8; 26.7%) groups. Dropout were mostly school commitments or travel related.Conclusions: Early findings suggest a trend towards dual improvement in sleep quality and PTSD symptom severity in adolescents with a sleep disturbance and PTSD receiving a group sleep intervention (SAASI). Further investigation in a properly powered RCT with detailed retention planning is indicated.

AB - Background: Trauma exposure prevalence and consequent post-traumatic stress disorder among South African adolescents are significant. Sleep disturbances are among the most frequently reported difficulties faced by those dealing with PTSD. The current study examined the feasibility and preliminary efficacy of the South African Adolescence Group Sleep Intervention on PTSD symptom severity and sleep disturbance.Method: Sixty-one adolescents with PTSD diagnoses and sleep disturbance were randomly assigned (1:1) to one individual and four group sessions of a sleep intervention (SAASI) or a control group. Participants completed the Child PTSD symptom scale for DSM5 (CPSS-5) and the Pittsburgh Sleep Quality Index (PSQI) among other sleep and psychiatric measures. The trial was registered on the Pan African Trial Registry (PACTR202208559723690).Results: There was a significant but similar decrease in PSQI scores in both groups over time indicating no overall intervention effect (Wald test = −2.18, p = .029), mean slope = −0.2 (95% CI: −0.37 to −0.02) (p = .583). On the CPSS-5, interaction between groups was also not significant (p = .291). Despite this overall finding, the mean difference in CPSS-SR-5 scores increased over time, with the difference between groups post-treatment -9.10 (95%CI: −18.00 to −0.21), p = .045 and the 1-month follow-up contrast - 11.22 (95%CI: −22.43 to −0.03), p = .049 suggesting that PTSD symptom severity decreased more in the intervention group than the control group. The dropout rate was higher than expected for both the intervention (n = 10; 32%) and control (n = 8; 26.7%) groups. Dropout were mostly school commitments or travel related.Conclusions: Early findings suggest a trend towards dual improvement in sleep quality and PTSD symptom severity in adolescents with a sleep disturbance and PTSD receiving a group sleep intervention (SAASI). Further investigation in a properly powered RCT with detailed retention planning is indicated.

KW - PTSD severity

KW - sleep disturbance

KW - adolescents

KW - sleep intervention

KW - task-shifting

KW - brief intervention

KW - group interveniton

KW - sleep quality

KW - Trastornos Del Sueño

KW - Stress Disorders, Post-Traumatic

KW - Calidad De Sueño

KW - Humans

KW - Male

KW - Ptsd Severity

KW - Gravedad Del Tept

KW - Intervención Del Sueño

KW - Group Intervention

KW - Female

KW - Psychotherapy, Group

KW - Adolescents

KW - Brief Intervention

KW - Cambio De Tareas

KW - Sleep Disturbance

KW - Sleep Wake Disorders

KW - Intervención Breve

KW - Pilot Projects

KW - Sleep Intervention

KW - Sleep

KW - Sleep Quality

KW - Adolescent

KW - Intervención Grupal

KW - Adolescentes

KW - South Africa

KW - Task-shifting

U2 - 10.1080/20008066.2024.2350217

DO - 10.1080/20008066.2024.2350217

M3 - Article

SN - 2000-8066

VL - 15

JO - European Journal of Psychotraumatology

JF - European Journal of Psychotraumatology

IS - 1

M1 - 2350217

ER -

A pilot randomised control study to investigate the effect of the South African Adolescence Group Sleep Intervention (SAASI) on adolescent sleep and PTSD

Abstract

Keywords

UN SDGs

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