Barriers and enablers to modifying sleep behavior in adolescents and young adults: A qualitative investigation

OBJECTIVE: Many young adults obtain less than the recommended sleep duration for healthy and safe functioning. Behavior change interventions have had only moderate success in increasing sleep duration for this cohort. This may be because the way young adults think about sleep, including their willingness and ability to change sleep behavior, is unknown. The purpose of the present study was to determine what changes, if any, young adults are willing to make to their sleep behavior, and to identify factors that may enable or prevent these changes. PARTICIPANTS: Fifty-seven young adults (16-25 years; 57% female) took part in focus groups addressing (a) willingness to change, (b) desired outcomes of change, and (c) barriers to change in regards to sleep behavior. METHODS: An inductive approach to data analysis was employed, involving data immersion, coding, categorization, and theme generation. RESULTS: Participants were willing to change sleep behavior, and had previously employed strategies including advancing bedtime and minimizing phone use, with limited success. Desired changes were improved waking function, advanced sleep onset, optimized sleep periods, and improved sleep habits. Barriers to making these changes included time demands, technology use, difficulty switching off, and unpredictable habits. Young adults want to improve sleep behavior and waking function; this is an important first step in modifying behavior. Notably, participants wanted more efficient and better quality sleep, rather than increasing sleep duration. CONCLUSION: The reported barriers to sleep, particularly using technology for social purposes, will require innovative and specialized strategies if they are to be overcome