UNASSIGNED: Five electronic databases were searched for randomized controlled trials of sleep health interventions initiated or conducted in school settings and in which behavioral sleep outcomes were measured. Cochrane risk of bias tools were used to assess study quality.
UNASSIGNED: From the 5303 database records and two papers from other sources, 21 studies (22 papers) met the inclusion criteria for this review. These studies involved 10 867 children and adolescents at baseline from 13 countries. Most studies (n = 15) were conducted in secondary schools. Sleep education was the most common intervention, either alone (n = 13 studies) or combined with other initiatives (stress management training, n = 2; bright light therapy, n = 1; health education, n = 1). Interventions were typically brief in terms of both the intervention period (median = 4 weeks) and exposure (median = 200 minutes). Behavioral outcomes included actigraphy-measured and self-reported sleep patterns, and sleep hygiene. All outcomes had high risk of bias or some concerns with bias. Sleep education interventions were typically ineffective. Later school start times promoted longer sleep duration over 1 week (1 study, high risk of bias).
UNASSIGNED: Current evidence does not provide school-based solutions for improving sleep health, perhaps highlighting a need for complex, multi-component interventions (e.g. whole-of-school approaches) to be trialed.
■搜索了五个电子数据库,以获取在学校环境中启动或进行的睡眠健康干预措施的随机对照试验,并在其中测量行为睡眠结果。使用Cochrane偏倚风险工具评估研究质量。
■来自5303数据库记录和来自其他来源的两篇论文,21项研究(22篇论文)符合本综述的纳入标准。这些研究涉及来自13个国家的10.867名基线儿童和青少年。大多数研究(n=15)是在中学进行的。睡眠教育是最常见的干预措施,单独(n=13项研究)或与其他举措(压力管理培训,n=2;强光疗法,n=1;健康教育,n=1)。就干预期(中位数=4周)和暴露期(中位数=200分钟)而言,干预措施通常很短。行为结果包括肌动测量和自我报告的睡眠模式,和睡眠卫生。所有结果都有较高的偏倚风险或一些偏倚担忧。睡眠教育干预通常是无效的。以后的开学时间促进了1周以上的睡眠时间(1项研究,偏见风险高)。
■目前的证据并没有为改善睡眠健康提供基于学校的解决方案,也许突出了对复杂的需求,多组分干预措施(如全校方法)进行试验。