Sleep

The role of the transdiagnostic sleep and circadian intervention in adolescent bedtime and sleep quality: a pilot study.

Duraccio K, Craig A, et al. • Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine • 2026

PubMed 42760394 DOI 10.1007/s44470-026-00180-x
TL;DR

TSC demonstrated improvements in behavioral sleep timing and perceived sleep quality in a community-based adolescent sample, even without detectable biological circadian phase shifts.

Key Findings

Results

The TSC intervention was associated with a significant earlier shift in sleep midpoint of approximately 30 minutes.

  • Sleep midpoint shifted earlier by approximately 30 minutes (p = .023, g = .591)
  • Effect size g = .591 indicates a moderate effect
  • Sample consisted of 31 adolescents with a mean age of 15.9 years (SD = 1.3)
  • Within-subject design assessed outcomes before and after the six-week TSC intervention
  • Sleep timing was measured via actigraphy
Results

Weekend sleep onset showed a significant earlier shift following the TSC intervention.

  • Weekend sleep onset improved with p = .003 and g = .856, indicating a large effect size
  • This was among the strongest effects observed in the study
  • Measurement was conducted via actigraphy pre- and post-intervention
  • The six-week intervention was community-based
Results

Subjective sleep quality improved significantly following the TSC intervention.

  • Pittsburgh Sleep Quality Index scores improved with p = .021, g = .452
  • Effect size g = .452 indicates a small-to-moderate effect
  • Subjective sleep quality was assessed via the Pittsburgh Sleep Quality Index (PSQI)
  • Improvement was observed despite no significant changes in objectively measured sleep duration or sleep onset latency
Results

No significant changes were observed in dim-light melatonin onset (DLMO) or the circadian misalignment index following the TSC intervention.

  • DLMO, a biological marker of circadian phase, did not shift significantly from pre- to post-intervention
  • The circadian misalignment index also showed no significant change
  • This indicates that behavioral improvements in sleep timing occurred without detectable biological circadian phase shifts
  • DLMO was assessed using standard dim-light melatonin onset protocols
Results

No significant changes were observed in total sleep duration, sleep onset latency, or chronotype following the TSC intervention.

  • Total sleep duration did not change significantly from pre- to post-intervention
  • Sleep onset latency showed no significant improvement
  • Chronotype, measured via the Morningness-Eveningness Questionnaire, did not change significantly
  • These null findings were observed despite significant improvements in sleep timing and subjective sleep quality
Results

No significant improvements were observed in mental health outcomes following the TSC intervention.

  • Mental health was assessed using the Depression Anxiety and Stress Scale-21 Item (DASS-21)
  • None of the mental health domains (depression, anxiety, stress) showed significant change
  • This was contrary to the study hypothesis that TSC would improve mental health outcomes
  • The sample included community-based adolescents with self-reported circadian misalignment
Methods

The study sample consisted of community-based adolescents with self-reported circadian misalignment who completed a six-week TSC intervention.

  • 31 adolescents completed the intervention (mean age = 15.9 years, SD = 1.3)
  • 45.2% were female and 67.7% identified as White
  • Participants self-reported circadian misalignment as an inclusion criterion
  • A within-subject (pre-post) design was used without a control group
  • Repeated-measure Generalized Linear Models were used to examine pre- to post-intervention differences

What This Means

This research suggests that a structured six-week sleep and circadian intervention called TSC (Transdiagnostic Intervention for Sleep and Circadian Dysfunction) can help teenagers shift their sleep timing earlier and feel that they sleep better, even when used in everyday community settings rather than controlled research environments. Among 31 teenagers who reported being 'night owls' or having misaligned sleep schedules, the program was linked to falling asleep about 30 minutes earlier on average (especially on weekends) and reporting better overall sleep quality by the end of the six weeks. However, the study also found important limitations to what the intervention changed. The biological clock marker — melatonin onset measured under dim light conditions — did not shift, meaning the teenagers' internal body clocks did not measurably change even though their sleep behavior did. Additionally, total sleep time, how long it took to fall asleep, chronotype (being a morning or evening person), and mental health symptoms like depression, anxiety, and stress did not significantly improve. This research suggests that TSC may be a useful tool for helping teenagers adopt earlier and more consistent sleep schedules in real-world settings, but it may not be sufficient on its own to shift the underlying biological clock or to address mental health concerns. The authors note that future studies should include a comparison group, follow participants longer after the intervention ends, and include more diverse populations to better understand how and for whom this intervention works.

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Citation

Duraccio K, Craig A, Kamhout S, Wright I, Jex J, Pattillo B, et al.. (2026). The role of the transdiagnostic sleep and circadian intervention in adolescent bedtime and sleep quality: a pilot study.. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine. https://doi.org/10.1007/s44470-026-00180-x