Accepted for/Published in: Interactive Journal of Medical Research
Date Submitted: Oct 3, 2018
Open Peer Review Period: Oct 5, 2018 - Nov 5, 2018
Date Accepted: Apr 9, 2019
(closed for review but you can still tweet)
Mobile App Use for Insomnia Self-management: Pilot Findings on Sleep Outcomes in Veterans
ABSTRACT
Background:
Sleep disturbance is a major health concern among post-9/11 Veteran. We report subjective and objective sleep results from a pilot trial assessing self-management-guided use of a mobile app (CBT-i Coach, based on cognitive behavioral therapy for insomnia) as an intervention for insomnia in military Veterans.
Objective:
A primary aim of this study was to evaluate changes in both subjective and objective sleep outcomes from pre- to post-intervention.
Methods:
Subjective outcomes included the Insomnia Severity Index, the Pittsburgh Sleep Quality Inventory, and sleep-related functional status. A wearable sleep monitor (WatchPATTM) measured objective sleep outcomes including sleep efficiency, percent rapid eye movement (REM) during sleep, sleep time, and sleep apnea. Thirty-eight participants were enrolled in the study, with 18 being withdrawn per the protocol due to moderate or severe sleep apnea, and 9 others who dropped out or withdrew. Thus, 11 participants completed the full 6-week CBT-i Coach self-management intervention (“completers”).
Results:
Completer results indicated significant improvements in subjective sleep measures, including sleep quality (t(10) = -3.07, p < .05) from pre- (M = 12.82, SD = 4.60) to post-intervention (M = 10.73, SD = 3.32), and sleep-related functioning (t(10) =.07, p < .05) from pre- (M = 13.86, SD = 3.69) to post-intervention (M = 15.379, SD = 2.94), and reduced reports of insomnia (t(10) = 4.14, p < .01) from pre- (M = 16.63, SD = 5.55) to post-intervention (M = 12.82, SD = 3.74). Among the objective measures, there were no significant changes in sleep efficiency and percent rapid eye movement (REM) sleep, although unexpectedly, objective sleep time significantly decreased from pre- to post-intervention (F(7.12, 18.17) = 7.12, p = .01).
Conclusions:
These findings suggest that the CBT-i Coach app can improve subjective sleep, and that incorporating objective sleep measures into future, larger clinical trials or clinical practice may yield important information, in particular, by detecting previously undetected sleep apnea. Clinical Trial: This pilot trial was registered on ClinicalTrials.gov as NCT02392000.
Citation
Per the author's request the PDF is not available.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.