JMIR Publications

ABSTRACT

Background:

Healthy sleep is important not only for physical health but also brain development in children. Several reports have pointed out that Japanese adults and children have later bedtimes and shorter sleep times compared to those in other countries, possibly because of Japanese culture and lifestyles. Therefore, an intervention tool suitable to the Japanese socio-cultural situation for improving children’s sleep problems in their early years is urgently needed.

Objective:

To provide appropriate sleep health literacy to caregivers and change their parenting behavior, we developed a smartphone app to allow a reciprocal interaction between caregivers and pediatric sleep experts. This article describes a preliminary study to examine the app’s basic design and functions and to establish its acceptability and usability in a small sample.

Methods:

Ten caregivers and infants (aged 18–28 months, 40% boys) living in Japan participated in the study. At the start of the trial, the e-Learning content regarding sleep health literacy was delivered via a smartphone. Thereafter, caregivers manually inputted recorded data about their own and their infant’s sleep habits for 8 consecutive days per month for 2 months. After pediatric sleep experts retrieved this information from the Osaka University server, they specified the problems and provided multiple sleep habit improvement suggestions to caregivers. In turn, caregivers selected one of the feasible pieces of advice to put into practice and reported their children’s sleep-related behaviors via the app. Actigraphy was used to monitor children’s sleep behaviors objectively. The concordance between the information provided by caregivers and the actigraphy data was assessed. The acceptability and usability of the app were evaluated using self-report questionnaires completed by caregivers; qualitative feedback was obtained via semi-structured interviews post-intervention.

Results:

There was no significant difference between the information provided by the caregivers and the actigraphy data for bedtimes and wake-up (P = .127 to .970). However, there was a difference between the actigraphy data and the caregivers’ reports for nighttime sleep duration and nighttime awakenings (P = .000 each), similar to prior findings. User feedback showed that six and five of the ten caregivers rated the app “easy to understand” and “easy to continue to use,” respectively. Additionally, six of the ten caregivers rated the app’s operativity as “satisfactory.” Although this was a short-term trial, children’s sleep habits, caregivers’ sleep health consciousness, and parenting behaviors improved to some extent.

Conclusions:

The present findings suggest that the app can easily be used and is acceptable by Japanese caregivers. Given the user feedback, the app has the potential to improve children’s sleep habits by sending individualized advice that fits families’ backgrounds and home lives. Further studies are needed to confirm the efficacy of the app, with the aim of social implementation.