School-based interventions to improve sleep duration: Lessons learned and future directions

Recent reports have shown that the majority of school-aged children and adolescents experience insufficient sleep duration making sleep health a significant public health concern. School-based sleep interventions that have the ability to reach large numbers of children simultaneously may be a viable strategy to combat this epidemic. The goal of this topical review is to examine published school-based interventions to identify lessons learned and provide suggestions for future research. Our findings show that school-based sleep interventions to date have been designed as both universal interventions for all students as well as targeted interventions delivered only to those identified as having sleep problems. Unfortunately, most interventions resulted in minimal change in sleep, with only 3 interventions improving sleep by more than 30 min per night. Education-based strategies alone are typically insufficient to produce substantial behavior change. The strategy of screening the most at-risk students and then providing individual and specifically targeted intervention may be an efficient use of resources that schools could utilize. Further work is needed to examine the feasibility and efficacy of school-based interventions in achieving clinically significant improvements in sleep duration at a larger scale to curb the epidemic of insufficient sleep in school-aged children and adolescents.