A school-based sleep hygiene education program for adolescents in Japan: a large-scale comparative intervention study

  • Yuichiro Otsuka
  • Yoshitaka KaneitaEmail author
  • Osamu Itani
  • Mikiko Tokiya
Original Article


Sleep hygiene education involves promoting good sleep habits in all aspects of lifestyle and behavior. In this study, we evaluated the effects of a sleep hygiene education program for Japanese high school students who did not have insomnia symptoms.Tenth-grade students (N = 2815; intervention, n = 1347; control, n = 1468) from 16 high schools in a provincial city in Japan participated in this cluster-controlled trial. In this program, teachers conducted a 5-min class based on various catchphrases once per week using teaching materials developed for this study (“Healthy Living Sleep Guidelines for High School Students”). Twelve classes were conducted. The baseline and follow-up surveys were performed. The difference between the groups was examined using an intention-to-treat principle with the full analysis set. We selected the generalized estimating equation for this analysis. The intention-to-treat analysis revealed that the intervention group presented significantly greater prevention of insomnia symptoms and short sleep duration (< 6 h) compared to the control group (adjusted odds ratio: 0.72 [95% confidence interval: 0.54–0.96], adjusted odds ratio 0.79 [95% CI 0.67–0.94]). However, there were no significant differences in odds ratios between the two groups for poor subjective sleep quality, excessive daytime sleepiness, and late bedtime.This sleep hygiene education program may be useful as a low-cost, highly valid, and accessible primary prevention method for insomnia symptoms. However, the applicability of this program for children of other ages and regions needs to be verified.


Education Adolescent Non-randomized controlled trial Insomnia Sleep hygiene 



We extend our sincere gratitude to the high school teachers for their invaluable participation.


This study was supported by JSPS KAKENHI (Grant number JP26507009).

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Committee of Oita University School of Medicine.

Informed consent

Informed consent was obtained from all study participants.


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Copyright information

© Japanese Society of Sleep Research 2019

Authors and Affiliations

  • Yuichiro Otsuka
    • 1
  • Yoshitaka Kaneita
    • 1
    Email author
  • Osamu Itani
    • 1
  • Mikiko Tokiya
    • 2
  1. 1.Division of Public Health, Department of Social MedicineNihon University School of MedicineTokyoJapan
  2. 2.Department of Public Health and Epidemiology, Faculty of MedicineOita UniversityYufuJapan

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