REST Pilot Study

Problem: Youth aging out of foster care experience profound stress, sleep disruption, and elevated risk for poor mental health and functional outcomes during the transition to adulthood. Disrupted sleep and dysregulated stress physiology (e.g., flattened diurnal cortisol rhythms) are plausible, modifiable mechanisms linking adversity to downstream outcomes, yet remain understudied in this population.

Purpose: This 2-year pilot study will (1) compare sleep regularity and diurnal cortisol rhythms between youth aging out of foster care and peers with stable housing, and (2) test the feasibility and preliminary effects of a stepwise sleep-regularity and mindfulness intervention (REST) among aging-out youth.

Innovation: REST integrates objective sleep measurement (actigraphy), diurnal cortisol curves, and a scalable, trauma-informed intervention that prioritizes circadian anchoring and adds mindfulness only when needed. The design combines cohort comparison with an embedded pilot randomized trial to strengthen mechanistic inference and future scalability.

Approach: Youth aging out of foster care (n≈80) and a stable-housing comparison cohort (n≈40–60) will complete baseline assessments including actigraphy, sleep diaries, salivary cortisol, resilience, stress, and functioning measures. Aging-out youth will be randomized to REST or an attention-matched control. REST is delivered over 8 weeks using a stepwise model: circadian anchoring (weeks 1–4), followed by added mindfulness for non-responders (weeks 5–8).

Impact: Findings will establish feasibility, generate effect size estimates, and clarify sleep–stress mechanisms to support a larger, multi-site trial aimed at improving resilience and transition outcomes for foster youth.