The Development and Application of a Resilience-Promoting Program Using Changes in Sleep-Related Habits in Korean Adolescents

Abstract

Objective: Resilience-promoting program which covers strategies to improve sleep health through modulation of sleep-related habits has been lacking. The authors aimed to develop a resilience-promoting program that incorporates the encouragement of healthy sleep habits. Methods: Fifty-eight adolescents (27 female, 46.6%; aged 13.78±0.82 years) were recruited to test the effectiveness of the program. Dur- ing the first and final sessions, several self-reported questionnaires, including the Connor-Davidson Resilience Scale (CD-RISC), the Smart- phone Addiction Scale–short version (SAS-SV), Hospital Anxiety and Depression Scale (HADS), Composite Scale of Morningness (CSM), In- somnia Severity Index (ISI), and a sleep habit-related questionnaires were administered to the adolescents. After the first session, adolescents were provided with an Actiwatch and were asked to wear the watch to the last session date. Multiple linear regression analyses were used to identify predictors of resilience and sleep quality.Results: The participants’ resilience, morningness, sleep quality, wake after sleep onset (WASO), and wakening frequency during the night changed significantly. Resilience at the last session was related to sleep quality (β=-0.394, p=0.005) at the last session when controlling for age, sex, and morningness. Sleep quality at the last session was related to the mean sun- light exposure time (β=-0.363, p=0.037) at the last session when controlling for age, sex, and WASO during the third week.Conclusion: This study found that four weekly sessions of resilience-promoting program improved resilience, sleep quality including objective actigraphic measures, and morningness. Improved resilience was related to better sleep quality.