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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.
A four-week group sleep intervention seems feasible in adolescents with PTSD and sleep disturbances in a low-resource South African setting.Utilising less specialised mental health resources such as nurses and counsellors in intervention delivery was feasible and effective.Preliminary results are promising and support further research to establish the efficacy of the intervention.
A four-week group sleep intervention seems feasible in adolescents with PTSD and sleep disturbances in a low-resource South African setting.Utilising less specialised mental health resources such as nurses and counsellors in intervention delivery was feasible and effective.Preliminary results are promising and support further research to establish the efficacy of the intervention.
摘要：
背景：南非青少年的创伤暴露率和随之而来的创伤后应激障碍很重要。睡眠障碍是处理PTSD的人所面临的最常报告的困难之一。本研究检查了南非青少年组睡眠干预对PTSD症状严重程度和睡眠障碍的可行性和初步疗效。方法：将61名患有PTSD诊断和睡眠障碍的青少年随机分配（1：1）到一个人和四个睡眠干预组（SAASI）或对照组。参与者完成了DSM5（CPSS-5）和匹兹堡睡眠质量指数（PSQI）的儿童PTSD症状量表，以及其他睡眠和精神病学指标。该试验已在泛非试验登记处登记(PACTR202208559723690)。结果：随着时间的推移，两组的PSQI评分均有显着但相似的下降，表明没有总体干预效果（Wald检验=-2.18，p=0.029），平均斜率=-0.2（95%CI：-0.37至-0.02）（p=.583）。在CPSS-5上，组间的相互作用也不显著(p=0.291)。尽管有这样的发现,CPSS-SR-5分数的平均差异随着时间的推移而增加，治疗后组间差异为-9.10（95CI：-18.00至-0.21），p=.045，1个月随访对比-11.22（95CI：-22.43至-0.03），p=.049表明干预组的PTSD症状严重程度比对照组降低更多。干预组（n=10;32％）和对照组（n=8;26.7％）的辍学率均高于预期。辍学主要是与学校承诺或旅行相关的。结论：早期发现表明，在接受集体睡眠干预（SAASI）的患有睡眠障碍和PTSD的青少年中，睡眠质量和PTSD症状严重程度有双重改善的趋势。指出了在具有详细保留计划的正确供电的RCT中进行进一步调查。
在资源匮乏的南非环境中，对患有PTSD和睡眠障碍的青少年进行为期四周的集体睡眠干预似乎是可行的。在干预实施中利用护士和辅导员等专业较少的心理健康资源是可行且有效的。初步结果是有希望的，并支持进一步研究以建立干预措施的功效。
在资源匮乏的南非环境中，对患有PTSD和睡眠障碍的青少年进行为期四周的集体睡眠干预似乎是可行的。在干预实施中利用护士和辅导员等专业较少的心理健康资源是可行且有效的。初步结果是有希望的，并支持进一步研究以建立干预措施的功效。
