O001 Providing feedback and guidance on sleep perceptions using sleep wearables improves insomnia: Findings from the randomised Novel Insomnia Treatment Experiment (“NITE”)

Abstract

Study Objectives Insomnia is diagnosed based on self-reported sleep complaints. There are often differences between objectively recorded and self-reported sleep (sleep-wake state discrepancy), which is well-documented but not well understood. This two-arm, parallel-group, single-blind, superiority randomised controlled trial examined whether monitoring sleep using wearable sleep-measurement devices and providing feedback with support for helpful interpretation of objective sleep data improved insomnia symptoms. Methods 113 (age M=47.53, SD=14.37, 64.9% female) individuals with insomnia symptoms (Insomnia Severity Index >= 10; ISI) from the community were randomised (permuted block randomization) to receive 5 weeks of (a) Feedback (n=57): feedback about objectively recorded sleep (actigraphy and optional EEG headband) with guidance for data interpretation and ongoing monitoring; (b) No-Feedback (n=56): sleep hygiene. Both conditions received one individual session and two check-in calls. The ISI (primary outcome), PROMIS Sleep Disturbance (SD), Sleep-Related Impairment (SRI), Depression, and Anxiety were assessed at baseline and post-intervention. Results 103 (91.2%) participants completed the study. Preliminary intention-to-treat multiple regression showed that after controlling for baseline symptoms, the Feedback condition (n=52) had lower ISI (p=.0069, d=0.53) and SD (p=.033, d=0.38), but differences in SRI, Depression and Anxiety were not meaningful (p-values>.37) compared to No-Feedback condition (n=51). Conclusion Providing feedback and guidance about objectively recorded sleep reduced insomnia severity and sleep disturbance in individuals with insomnia symptomology. With increasing access to wearable sleep-measurement devices, these findings explore how objective sleep measures, in combination with data interpretation guidance, could supplement and enhance current insomnia treatment. Australian New Zealand Clinical Trials Registry: ACTRN12619001636145.

Investigating the subjective and objective efficacy of a cognitive behavioural therapy for insomnia (CBT‐I)‐based smartphone app on sleep: A randomised controlled trial

“…Generally, providing feedback on sleep seems to be beneficial regarding insomnia severity and sleep disturbances in individuals with significant insomnia symptoms (Spina et al, 2023). However, it is also important to note, that despite potential improvements in sleep parameters and SOSD, it is not yet fully understood, whether reporting feedback on objective sleep might also possibly result in negative effects, for example, an increase of obsession with sleep due to selected attention, a key pathological feature of insomnia.…”

Tailoring cognitive behavioural therapy for insomnia across contexts, conditions, and individuals: What do we know, where do we go?

“…Further, recent development of sleep‐measuring wearables sees these devices increasingly integrated into sleep interventions (Glazer Baron et al, 2022). For example, one study provided regular feedback on wearable‐measured sleep for individuals with insomnia (Spina et al, 2023), and another added wearable‐enabled sleep data synchronisation to a digital behavioural therapy to demonstrate greater engagement and improvements in sleep (Aji et al, 2022). Real‐world sleep–wake patterns from wearable devices have also been implemented to recommend personalised sleep schedules to maximise alertness (Song et al, 2023).…”