Treating subclinical and clinical symptoms of insomnia with a mindfulness-based smartphone application: A pilot study

Tiffany Low; Russell Conduit; Prerna Varma; Hailey Meaklim; Melinda L Jackson

doi:10.1016/j.invent.2020.100335

Treating subclinical and clinical symptoms of insomnia with a mindfulness-based smartphone application: A pilot study

Internet Interv. 2020 Aug 20:21:100335. doi: 10.1016/j.invent.2020.100335. eCollection 2020 Sep.

Authors

Tiffany Low¹, Russell Conduit¹, Prerna Varma^{1

2}, Hailey Meaklim^{1

2}, Melinda L Jackson^{1

2}

Affiliations

¹ School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.
² Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia.

Abstract

Background/objectives: Emerging research suggests that face-to-face group mindfulness-based therapies are an effective intervention for insomnia. This pilot study examined the effectiveness of a mindfulness-based smartphone application for improving objectively-measured sleep, self-reported sleep, insomnia severity, pre-sleep arousal and daytime mood.

Method: A community sample of 23 adults with subclinical to moderately severe symptoms of insomnia were randomized to either a mindfulness or progressive muscle relaxation (PMR) smartphone application for 40 or 60 days. Objective sleep outcomes assessed using actigraphy, and self-report measures of total wake time, cognitive and somatic pre-sleep arousal, and daytime positive and negative affect were assessed for 14 nights at baseline and post-intervention. Insomnia severity was recorded at baseline and post-intervention.

Results: A greater reduction in sleep onset latency was observed in the mindfulness group over time, relative to the PMR group. The mindfulness group also reported medium effect size improvements for sleep efficiency. No significant interaction effects were found for self-reported sleep measures, however, main effects of time were found for both groups for total wake time, insomnia severity, cognitive pre-sleep arousal, and daytime positive and negative affect.

Conclusions: These preliminary findings suggest that both mindfulness and PMR smartphone applications have the potential to improve symptoms of insomnia. In particular, this mindfulness-based smartphone application may improve sleep onset latency and reduce the duration of night-awakenings. Further research exploring digital therapeutics as a self-help option for those with insomnia is needed.

Keywords: ANOVA, analysis of variance; ISI, Insomnia Severity Index; MBSR, mindfulness-based stress reduction; Mindfulness; NA, negative affect; PA, positive affect; PMR, progressive muscle relaxation; PSAS (Cog), cognitive subscale of Pre-Sleep Arousal Scale; PSAS (Som), somatic subscale of Pre-Sleep Arousal Scale; PSAS, Pre-Sleep Arousal Scale; Pre-sleep arousal; Progressive muscle relaxation; SFI, sleep fragmentation index; SOL, sleep onset latency; Sleep; Smartphone applications; TIB, time in bed; TST, total sleep time; TWT, total wake time; WASO, wake after sleep onset.