JMIR Publications

ABSTRACT

Background:

Over 30% of Americans report regular sleep disturbance and consumers are increasingly seeking strategies to improve sleep. Self-guided mindfulness mobile apps may help individuals improve their sleep. Despite the recent proliferation of sleep content within commercially available mindfulness apps, there is little research on how consumers are using these apps for sleep.

Objective:

We conducted a cross-sectional survey in subscribers of the mindfulness app Calm and described and compared how good sleepers, poor sleepers, and those with self-reported insomnia use the app for sleep.

Methods:

Participants were paying subscribers of Calm and had used a sleep component of Calm in the last 90 days. Participants were asked to complete an investigator-developed survey that included seven questions about sleep disturbance and use of Calm for sleep. Based on self-reports of sleep disturbances, and of insomnia diagnosis, participants were categorized as “good sleepers,” “poor sleepers,” or “insomnia.” Chi-square tests compared reasons for downloading the app and usage patterns across participants with and without sleep disturbance.

Results:

Analyses included 9868 survey respondents. Approximately 10% of participants (n=1008, 10.289%) were good sleepers, 77% were poor sleepers (n=7565, 77.218%), and 11% reported a diagnosis of insomnia (n=1039, 10.605%). The sample was majority White (n=8185, 83.546%), non-Hispanic (n=8929, 94.757%), and female (n=8166, 85.257%). The most common reasons for sleep disturbances were racing thoughts (n=7084, 82.334%), followed by stress or anxiety (n=6307, 73.303%). Poor sleepers and those with insomnia were more likely to have downloaded Calm to improve sleep (χ2=1548.835, p<.001), reduce depression or anxiety (χ2=15.521, p<.001) or improve overall health (χ2=57.630, p<.001). Respondents with insomnia used Calm most often (M=5.417 days/week), followed by poor sleepers (M=5.043 days/week; F=21.544, p<.001). The most common time to use Calm was while lying down to sleep (7607/9686, 78.536%), and bedtime use was more common among poor sleepers and those with insomnia (χ2=382.708, p<.001). Those with insomnia were also more likely to use Calm after waking up at night (χ2=410.338, p<.001). Most participants tried to use Calm on a regular basis (5031/8597, 58.520%), but regular nighttime use was most common among those with insomnia (646/977, 66.121%), followed by poor sleepers (4040/6930, 58.297%; χ2=109.306, p<.001).

Conclusions:

We are the first to report that subscribers to a popular, consumer-based mindfulness-based meditation app used this app primarily for sleep. Our findings suggest that individuals with sleep disturbances, including insomnia, are using mindfulness meditation apps to help them sleep. Randomized controlled trials are needed to understand whether consumer-based meditation mobile apps are efficacious in improving sleep. These findings also highlight the need for content within consumer-based meditation apps that is designed for users who have difficulty falling asleep or returning to sleep after waking in the night. Clinical Trial: N/A