JMIR Publications

ABSTRACT

Background:

Sleep problems are quite common among young children, and are often a burden for parents and a hinderance to children’s development. While behavioral therapy has been proven to be effective in reducing sleep problems in children, lack of access to professionals who can provide effective support is a major barrier for many caregivers. Pediatric sleep experts have thus begun developing apps and online services for caregivers. Despite the significant influence of cultural and family factors on children's sleep, little effort has gone into developing cultural or family-tailored interventions.

Objective:

This study examined the effectiveness of the interactive smartphone application “Nenne Navi,” which provides cultural and family-tailored suggestions for improving sleep habits in young Japanese children through community-based long-term trials.

Methods:

This study employed the community-based approach to recruit participants from Higashi-Osaka city (Japan) who met one or more of the following eligibility criteria for sleep problems; 1) sleeping after 10:00 p.m., 2) less than 9 hours of nighttime sleep, or 3) frequent nighttime awakenings. A total of 87 Japanese caregivers with young children (mean 19.50 months) were recruited and assigned to the app usage group (as intervention group) or the video only group (as control group). Both groups received educational video content regarding sleep health literacy. The caregivers in the intervention group used the app which provides family-tailored suggestions once per month for 1 year.

Results:

A total of 92% of the caregivers in app usage group completed one year of the intervention. The participants' overall evaluation of the app was positive. The wake-up time was advanced (P = .014) and the sleep onset latency was decreased (P = .006) significantly in the app usage group at the 13th month compared to the video only group. Moreover, multiple regression analysis showed that decreased social jetlag (P = .033) and increased sleep onset latency SD (P = .015) in children predicted significant enhancement of development in social relationships with adults. At six months after the completion of the app’s usage, all caregivers reported continuation of the new lifestyle.

Conclusions:

The present findings suggest that the app “Nenne Navi” has high continuity in community use and can improve sleep habits in young Japanese children. The present findings suggest that interventions for sleep habits of young children may lead to the enhancement of children's social development. Future studies must focus on the effectiveness of the app in other regions with different regional characteristics, and neuroscientific investigations on how changes in sleep impact brain development.