JMIR Publications

ABSTRACT

Background:

Chronic sleep disturbance is highly prevalent among United States (U.S.) employees and is associated with costly productivity impairment. Mindfulness interventions improve both sleep (i.e., insomnia, daytime sleepiness) and productivity outcomes, and mobile apps provide a scalable means of intervention delivery for employees. However, few studies have examined the effects of mindfulness mobile apps among employees, and no research to date has tested the role of sleep improvements as a potential mechanism of action for productivity outcomes.

Objective:

This study examined the effects of Calm, a consumer-based mindfulness app, on productivity impairment among retail employees through indirect effects of change in insomnia symptoms and daytime sleepiness.

Methods:

This study was a secondary analysis of data from a randomized controlled trial (N=1029) comparing use of Calm (n=585; a subset of individuals with elevated sleep disturbance also had access to brief sleep coaching with Calm, n=101) to a waitlist control (n=444) for 8 weeks among employees of a large retail employer in the U.S. Insomnia symptom severity, daytime sleepiness, and productivity impairment (i.e., absenteeism, presenteeism, overall productivity impairment, and non-work activity impairment) were assessed at baseline and weeks two, four, six, and eight. Indirect effects were evaluated with latent growth curve modeling to test whether the Calm intervention (Calm group vs. waitlist control) was effective in reducing work productivity impairment through changes in sleep disturbance.

Results:

No significant main effects of Calm on productivity impairment were detected for any outcomes (ps>.14), with the exception of non-work activity impairment models, in which Calm reduced non-work activity impairment over time (p=.01; p=.02 for insomnia and sleepiness models, respectively). Significant indirect effects of insomnia were detected for presenteeism (p=.002), overall work productivity (p=.01), and non-work activity impairment (p=.002), such that Calm produced significantly greater reductions in insomnia symptoms (relative to waitlist control), and decreases in insomnia were associated with decreases in work productivity impairment. There was no significant indirect effect of change in insomnia on change in absenteeism (p=.20). Furthermore, we detected no significant indirect effects of daytime sleepiness on any of the four productivity impairment outcomes examined (ps>.59).

Conclusions:

We found that the beneficial effects of Calm on sleep have indirect benefits for productivity impairment (i.e., presenteeism, overall work productivity impairment, and non-work activity impairment). There were no overall main effects of Calm on productivity impairment outcomes, however, insomnia appears to be a mechanism that is associated with benefits for employee productivity. This is one of the first studies to suggest that the benefits of a mindfulness meditation mobile app for sleep may also indirectly confer benefits for productivity outcomes when implemented in the workplace. Additional research is needed to confirm these findings in other employee samples. Clinical Trial: ClinicalTrials.gov NCT05120310