The Good Night Project. Behavioural Sleep Interventions for Children with ADHD: A Randomised Controlled Trial

The Good Night Project is an evidence-based project aimed to design, implement and evaluate an RCT of behavioural interventions to improve sleep for children aged 5-12 years with ADHD and their primary caregivers in the Kingdom Saudi Arabia. The project was developed by systematically reviewing the literature. From the available, high quality literature using an RCT design (n=4), a group of behavioural interventions were identified using the behaviour change techniques taxonomy BCTs (Chapter two). Health professionals and caregivers were asked to rank these interventions from the most important interventions to the less important interventions using a Delphi method in two rounds (Chapter three). Their recommendations were considered when preparing the final version of the intervention. The 34-page Good Night Project was developed as a guide, translated from English to Arabic. Sleep habits cards and a video clip were also available to help children and their caregivers to promote sleep hygiene. The intervention, using these materials, was delivered by the psychologists to the caregivers in three sessions over three weeks, with each session lasting for three hours. The project was completed in the Kingdom of Saudi Arabia using a randomised controlled trial (RCT) design (Chapter four). Due to the high attrition rate, the number of participants who dropped out (n=61) which is more than 80% of the eligible participants, the study aim has been changed to examine the feasibility of the project instead of the efficacy (Chapter four). The results indicated that the Good Night Project is not feasible at this stage due to high attrition rate, although there is some tentative evidence of positive outcomes for those who completed the intervention. Thus, a further study is required using focus groups or experience-based co-design in order to explore factors that affect parents’ ability to complete the intervention. Following this, a further feasibility study is recommended taking into account the changes indicated to improve acceptability. General discussion about the project including summary of the results, implication for practice and for future research and contribution to knowledge including behavioural change interventions, culturally adapting interventions and sleep in children with ADHD are considered (Chapter five).