학술논문
The CLASS Study (Circadian Light in Adolescence, Sleep and School): protocol for a prospective, longitudinal cohort to assess sleep, light, circadian timing and academic performance in adolescence.
Document Type
Academic Journal
Author
Stone JE; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia julia.stone@monash.edu.; Wiley J; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.; Chachos E; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.; Hand AJ; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.; Lu S; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.; Raniti M; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.; Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.; Department of Paediatrics, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia.; Klerman E; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA.; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA.; Lockley SW; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA.; Carskadon MA; Department of Psychiatry & Human Behavior, Chronobiology & Sleep Research Laboratory, EP Bradley Hospital, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA.; Phillips AJK; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.; Bei B; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.; Rajaratnam SMW; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Source
Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
Subject
Language
English
Abstract
Background: During adolescence, sleep and circadian timing shift later, contributing to restricted sleep duration and irregular sleep-wake patterns. The association of these developmental changes in sleep and circadian timing with cognitive functioning, and consequently academic outcomes, has not been examined prospectively. The role of ambient light exposure in these developmental changes is also not well understood. Here, we describe the protocol for the Circadian Light in Adolescence, Sleep and School (CLASS) Study that will use a longitudinal design to examine the associations of sleep-wake timing, circadian timing and light exposure with academic performance and sleepiness during a critical stage of development. We also describe protocol adaptations to enable remote data collection when required during the COVID-19 pandemic.
Methods: Approximately 220 healthy adolescents aged 12-13 years (school Year 7) will be recruited from the general community in Melbourne, Australia. Participants will be monitored at five 6 monthly time points over 2 years. Sleep and light exposure will be assessed for 2 weeks during the school term, every 6 months, along with self-report questionnaires of daytime sleepiness. Circadian phase will be measured via dim light melatonin onset once each year. Academic performance will be measured via national standardised testing (National Assessment Program-Literacy and Numeracy) and the Wechsler Individual Achievement Test-Australian and New Zealand Standardised Third Edition in school Years 7 and 9. Secondary outcomes, including symptoms of depression, anxiety and sleep disorders, will be measured via questionnaires.
Discussion: The CLASS Study will enable a comprehensive longitudinal assessment of changes in sleep-wake timing, circadian phase, light exposure and academic performance across a key developmental stage in adolescence. Findings may inform policies and intervention strategies for secondary school-aged adolescents.
Ethics and Dissemination: Ethical approval was obtained by the Monash University Human Research Ethics Committee and the Victorian Department of Education. Dissemination plans include scientific publications, scientific conferences, via stakeholders including schools and media.
Study Dates: Recruitment occurred between October 2019 and September 2021, data collection from 2019 to 2023.
Competing Interests: Competing interests: JES, MR, EC, AJH, SL, JW, MAC and BB have no conflicts to declare. AJKP was an investigator on projects supported by the CRC for Alertness, Safety and Productivity, and he has received research funding from Versalux and Delos. EBK reports (non-government, non-university): Travel support from World Conference of Chronobiology, Gordon Research Conference, Sleep Research Society, Santa Fe Institute, German Sleep Society (DGSM); Consulting/grant reviews income from Puerto Rice Science, Technology, and Research Trust, National Sleep Foundation, Sanofi-Genzyme; Family member owns Chronsulting. SWL has had a number of commercial interests in the last 2 years (2019–2021). His interests were reviewed and managed by Mass General Brigham in accordance with their conflict of interest policies. No interests are directly related to the research or topic reported in this paper but, in the interests of full disclosure, are outlined below. SWL has received consulting fees from the EyeJust, Rec Room, Six Senses, and Stantec; and has current consulting contracts with Akili Interactive; Apex 2100; Consumer Sleep Solutions; Hintsa Performance AG; KBR Wyle Services, Light Cognitive; Lighting Science Group Corporation/HealthE; Look Optic; Mental Workout/Timeshifter and View. He has received honoraria and travel or accommodation expenses from MIT, Roxbury Latin School, and University of Toronto, and travel or accommodation expenses (no honoraria) from Wiley; and royalties from Oxford University Press. He holds equity in iSleep Pty. He has received an unrestricted equipment gift from F. Lux Software LLC, and holds an investigator-initiated grant from F. Lux Software. He has a Clinical Research Support Agreement and a Clinical Trials Agreement with Vanda Pharmaceuticals. He is an unpaid Board Member of the Midwest Lighting Institute (non-profit). He was a Program Leader for the CRC for Alertness, Safety and Productivity, Australia, through an adjunct professor position at Monash University (2015–2019). He is currently a part-time faculty member at the University of Surrey. He has served as a paid expert in legal proceedings related to light, sleep and health. SMWR was a Program Leader for the CRC for Alertness, Safety and Productivity, Australia, and currently serves as the Chair of the Sleep Health Foundation. SMWR reports grants from Vanda Pharmaceuticals, Philips Respironics, Cephalon, Rio Tinto and Shell and receiving equipment support and consultancy fees through his institution from Vanda, Circadian Therapeutics, Optalert, Tyco Healthcare, Compumedics, Mental Health Professionals Network and Teva Pharmaceuticals, which are not related to this paper.
(© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Methods: Approximately 220 healthy adolescents aged 12-13 years (school Year 7) will be recruited from the general community in Melbourne, Australia. Participants will be monitored at five 6 monthly time points over 2 years. Sleep and light exposure will be assessed for 2 weeks during the school term, every 6 months, along with self-report questionnaires of daytime sleepiness. Circadian phase will be measured via dim light melatonin onset once each year. Academic performance will be measured via national standardised testing (National Assessment Program-Literacy and Numeracy) and the Wechsler Individual Achievement Test-Australian and New Zealand Standardised Third Edition in school Years 7 and 9. Secondary outcomes, including symptoms of depression, anxiety and sleep disorders, will be measured via questionnaires.
Discussion: The CLASS Study will enable a comprehensive longitudinal assessment of changes in sleep-wake timing, circadian phase, light exposure and academic performance across a key developmental stage in adolescence. Findings may inform policies and intervention strategies for secondary school-aged adolescents.
Ethics and Dissemination: Ethical approval was obtained by the Monash University Human Research Ethics Committee and the Victorian Department of Education. Dissemination plans include scientific publications, scientific conferences, via stakeholders including schools and media.
Study Dates: Recruitment occurred between October 2019 and September 2021, data collection from 2019 to 2023.
Competing Interests: Competing interests: JES, MR, EC, AJH, SL, JW, MAC and BB have no conflicts to declare. AJKP was an investigator on projects supported by the CRC for Alertness, Safety and Productivity, and he has received research funding from Versalux and Delos. EBK reports (non-government, non-university): Travel support from World Conference of Chronobiology, Gordon Research Conference, Sleep Research Society, Santa Fe Institute, German Sleep Society (DGSM); Consulting/grant reviews income from Puerto Rice Science, Technology, and Research Trust, National Sleep Foundation, Sanofi-Genzyme; Family member owns Chronsulting. SWL has had a number of commercial interests in the last 2 years (2019–2021). His interests were reviewed and managed by Mass General Brigham in accordance with their conflict of interest policies. No interests are directly related to the research or topic reported in this paper but, in the interests of full disclosure, are outlined below. SWL has received consulting fees from the EyeJust, Rec Room, Six Senses, and Stantec; and has current consulting contracts with Akili Interactive; Apex 2100; Consumer Sleep Solutions; Hintsa Performance AG; KBR Wyle Services, Light Cognitive; Lighting Science Group Corporation/HealthE; Look Optic; Mental Workout/Timeshifter and View. He has received honoraria and travel or accommodation expenses from MIT, Roxbury Latin School, and University of Toronto, and travel or accommodation expenses (no honoraria) from Wiley; and royalties from Oxford University Press. He holds equity in iSleep Pty. He has received an unrestricted equipment gift from F. Lux Software LLC, and holds an investigator-initiated grant from F. Lux Software. He has a Clinical Research Support Agreement and a Clinical Trials Agreement with Vanda Pharmaceuticals. He is an unpaid Board Member of the Midwest Lighting Institute (non-profit). He was a Program Leader for the CRC for Alertness, Safety and Productivity, Australia, through an adjunct professor position at Monash University (2015–2019). He is currently a part-time faculty member at the University of Surrey. He has served as a paid expert in legal proceedings related to light, sleep and health. SMWR was a Program Leader for the CRC for Alertness, Safety and Productivity, Australia, and currently serves as the Chair of the Sleep Health Foundation. SMWR reports grants from Vanda Pharmaceuticals, Philips Respironics, Cephalon, Rio Tinto and Shell and receiving equipment support and consultancy fees through his institution from Vanda, Circadian Therapeutics, Optalert, Tyco Healthcare, Compumedics, Mental Health Professionals Network and Teva Pharmaceuticals, which are not related to this paper.
(© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)