“Goodnight, Poor Sleep”: A randomized-controlled trial of a brief, peer-led, psychological sleep intervention for university students

STUDY OBJECTIVES: This study evaluated the efficacy of Goodnight, Poor Sleep, a brief, single-session, peer-delivered sleep intervention based on cognitive behavioural therapy for insomnia, in improving sleep, daytime functioning, and mental health in university students. METHODS: In this 3-week, parallel-group, open-label randomized controlled trial, 178 university students (17-25yrs; 77% female) were randomly assigned (1:1) to either treatment (n = 89) or waitlist control groups (n = 89). Primary outcomes were sleep diary-assessed sleep onset latency, wake after sleep onset, total sleep time, and sleep efficiency. Secondary outcomes included sleep hygiene, insomnia severity, daytime sleepiness, fatigue, depression, anxiety, substance-related difficulties, and objective sleep (actigraphy). Primary outcomes were assessed at baseline, 1-week post-treatment, and 2-weeks post-treatment, and analysed using linear mixed models, with an alpha of 0.010 (adjusted for multiple hypothesis testing). RESULTS: No significant group differences were observed for primary sleep diary outcomes (ps > 0.010), although both groups improved over time (ps < 0.010). Compared to control, the treatment group showed greater post-treatment improvements in sleep hygiene (adjusted mean difference = 0.18 [95% CI: 0.11-0.25]; d = 0.78), insomnia severity (-2.03 [-2.83 to -1.23]; d = -0.74), fatigue (-3.40 [-4.97 to -1.83]; d = -0.64), and depressive symptoms (-0.86 [-1.50-0.21]; d = -0.40), all ps ≤ 0.010. There were no significant interaction effects for daytime sleepiness, anxiety, substance-related difficulties, or actigraphy outcomes. CONCLUSIONS: Findings provide preliminary support for Goodnight, Poor Sleep in improving insomnia, fatigue, and depression in university students, though not sleep diary outcomes. Further research with active comparators, longer-term follow-up, and blinded assessments is recommended. CLINICAL TRIAL REGISTRATION: This trial was registered with the Australian and New Zealand Clinical Trials Registry, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12622000254796. TRIAL ID: ACTRN12622000254796. Trial name: Goodnight Poor Sleep: Evaluating a Brief Sleep Intervention for University Students. STATEMENT OF SIGNIFICANCE: This study is the first to examine the efficacy of Goodnight, Poor Sleep, a brief, single-session, and peer-delivered sleep treatment for university students. Results suggest that Goodnight, Poor Sleep may be a low-barrier option for improving insomnia, as well as associated symptoms of daytime fatigue and depression in this underserved group. These findings are important, given the high prevalence of sleep disturbances and mental health problems among university students, which often remain untreated due to barriers such as the lengthy treatment duration and long waitlists associated with traditional cognitive behavioural therapy for insomnia. They also highlight possibilities for the dissemination of Goodnight, Poor Sleep as a first-line intervention for student sleep difficulties in a stepped-care model.