0746 Designing Realistic Management of Insomnia in Teens (DREAM-IT): Perspectives on CBT-I from Teens, Parents, and Providers

Abstract Introduction Cognitive Behavioral Therapy for Insomnia (CBT-I) has been established as effective for adults, but less research has been done on its appropriateness for teens. Using a patient-centered approach, we aimed to elicit perspectives on the acceptability and feasibility of CBT-I for teens. Methods Teens and parents were recruited via social media, and behavioral sleep medicine providers were recruited via listservs. Focus groups discussed utility, barriers, parent involvement, and potential adaptations for each CBT-I component. We conducted 10 teen focus groups (N = 76, 51% female, 21% male, 28% non-binary; 55% White), 6 parent groups (N = 51, 55% female, 43% male, and 2% non- binary, 47% White), and 2 provider groups (N = 18, 78% female, 17% male, 5% non-binary, 83% White). Providers were predominantly psychologists (78%) and were in practice for M = 9.9 years, SD = 8.09. Results Over 60% of teens were “not at all likely” to follow the stimulus control guideline of only using their bed for sleep; a notable barrier included lack of access to other spaces in the home. However, 65% of teens reported willingness to practice sleep restriction, with the adaptation of a two-hour later weekend wake time. Parents were very willing to enforce and/or implement recommendations with their teens, but most teens wanted little or no parent involvement. Providers reported only using sleep logs with teens either “not at all” (14%), “occasionally” (57%), or “half the time” (29%). Similarly, 72% of providers stated that they only discuss cognitive restructuring with teens either “occasionally” or “half the time”. For sleep restriction, most providers (83%) supported taking a more naturalistic, flexible approach. Across stakeholders, limiting screens after bedtime was considered more feasible than before bedtime, and distraction (e.g., listening to audio) was preferred over formal relaxation techniques. Conclusion Stakeholder perspectives highlighted the need to adapt CBT-I components for teens, and identified adaptations that were acceptable for teens, and already utilized by providers. Additional focus groups will further assess the acceptability and feasibility of adaptations prior to implementation in an RCT. Support (if any) Grant #: 249-SR-21 from the American Academy of Sleep Medicine Foundation.