LAUSR

Sleep disturbances among Japanese university students negatively affect their academic performance and mental health. Student habits, such as naps and using smartphones in bed, may lead to sleep problems. We hypothesized the Sleep Health through University Student Habits (SHUSH) program, a four-week cognitive-behavioral therapy for insomnia intervention, would improve sleep disturbances in university students. We used a pretest-posttest, single arm pilot study design and evaluated the feasibility and preliminary efficacy of SHUSH. Occupational therapy and physical therapy students (N = 18) in a university with self-reported sleep disturbances (Insomnia Severity Index; ISI score ≥ 9) were offered 90-minutes of sleep education (e.g., two-process model of sleep regulation, stimulus control, and sleep hygiene) then prescribed personalized sleep restriction therapy (SRT) and stimulus control therapy (SCT) goals based upon 10-days of sleep diary data. This was followed by weekly 15-minute individualized meetings for three consecutive weeks; SRT and SCT goals were titrated based upon sleep diaries, and occupational therapists supported treatment adherence. Assessments included validated Japanese versions of sleep-related (e.g., sleep disturbance), mental health-related (e.g., depression) and sleep diary (e.g., sleep efficiency) variables. Dependent t-tests (d) and Wilcoxon rank sum tests (r) were used to test differences between baseline and posttest assessments. There were 15 students who completed SHUSH with a mean age of 19.7 years; 9 were women. Improvements were found in sleep disturbance (r = 0.843), sleep quality (r = 0.851), daytime sleepiness (d = 0.762), sleep hygiene practice (d = 1.216) and change from an eveningness towards a morningness circadian preference (d = 0.990). Anxiety (d = 0.604) and depression (d = 0.729) improved. Sleep onset latency (r = 0.851), nighttime awakening (r = 0.514), and sleep efficiency (r = 0.880) also improved. Participants were satisfied with the SHUSH group-based education, one-on-one therapist meetings, and program brevity; there were no adverse events. SHUSH is a feasible and preliminarily effective sleep improvement program for reducing sleep disturbances among Japanese university students. Improved sleep was associated with improved mental health and sleep-promoting behaviors. A randomized controlled trial of SHUSH is recommended. Fulbright U.S. Scholar Award to Japan