0436 Combining Insomnia Therapy with Sleep Tracking Using Wearables: Effects of a CBT-I-based App on Sleep - A RCT Study

Abstract Introduction Due to the gap in non-pharmacological insomnia treatment, effective and validated digital solutions are urgently needed. So far, digital cognitive behavioral therapy for insomnia (CBT-I) options are comprised of a therapy program and subjective measurements in form of a sleep diary. Objective sleep measurements are usually not included. Here, we evaluate an innovative smartphone app (NUKKUAA®), combining i) a CBT-I-based sleep training with ii) subjective as well as iii) objective sleep monitoring via a wearable heart rate (HR) sensor, and iv) feedback based on such objective data. A RCT study was conducted to investigate effects on sleep and subjective-objective sleep discrepancies (SOSD). Methods Fifty-seven self-reported poor sleepers (20-76 years; MAge=45.67±16.38; 39 female) were randomly assigned to an experimental group (EG, n=28) or a waitlist control group (CG, n=29). During a 6-week intervention phase, the EG used the CBT-I-based app program including subjective and objective sleep monitoring as well as feedback on their sleep, while the CG used sleep monitoring only. Sleep was measured i) subjectively with questionnaires (Insomnia Severity Index, ISI; Pittsburgh Sleep Quality Index, PSQI), ii) objectively with ambulatory polysomnography (PSG), and iii) continuously via a HR sensor and sleep diaries. Results Analyses revealed interactions for ISI (p=.003, ƞ2part=.11) and PSQI (p=.050, ƞ2part=.05), indicating training-specific improvements for EG, yet not for CG. While PSG-derived outcomes appear to be less training-specific, a tendential reduction in wake after sleep onset (WASO) was found in EG (p=.061, d=0.55). Regarding changes in SOSD, results indicate a SOSD reduction during intervention for total sleep time in both groups, while improvements for sleep efficiency, sleep onset latency and WASO were found in EG only (p’s≤.022, d≥0.46). Conclusion The findings indicate beneficial effects of an innovative smartphone app on sleep and SOSD. More scientific evaluation of such digital programs is needed in order to ultimately help reducing the gap in non-pharmacological insomnia treatment and provide affected individuals with sufficient treatment options and effective, low-threshold support for their sleep problems. Support (if any) PT was partly supported by the FWF/Austrian Science Fund (W 1233-B).