The Design, Implementation and Evaluation of a Mobile App to Treat Insomnia
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Type
ThesisThesis type
Doctor of PhilosophyAuthor/s
Aji, MelissaAbstract
The aim of this thesis was to design, implement and evaluate a new mobile behavioural sleep therapy application for insomnia (SleepFix®). The rationale behind this research is the high prevalence rates of insomnia and a lack of trained clinicians to provide face-to-face psychological ...
See moreThe aim of this thesis was to design, implement and evaluate a new mobile behavioural sleep therapy application for insomnia (SleepFix®). The rationale behind this research is the high prevalence rates of insomnia and a lack of trained clinicians to provide face-to-face psychological therapy. The first study used a mixed-methods approach to understand the user needs and preferences of individuals with insomnia. Several design requirements were considered important for engagement by end-users, such as the inclusion of sleep tracking, alarms and personalised features. The next study was a systematic review critically assessing evidence for the design, implementation and evaluation of mobile apps for insomnia. Only 15 papers describing a total of 8 apps were identified. The majority of these papers described the design and implementation. There were very few papers evaluating efficacy with only one adequately powered randomised controlled trial (RCT), stressing the need for further evidence-based apps. To assess the implementation outcomes of SleepFix, a pilot feasibility study was conducted showing the app was highly engaging, acceptable and potentially efficacious. Statistically significant and clinically meaningful improvements were reported in insomnia severity. The final study aimed to assess the adjunctive use of a wearable device synchronised with SleepFix enhanced outcomes. This was the first RCT to assess the effect of an integrated wearable with a mobile app for insomnia. One-hundred and twenty-eight individuals with insomnia symptoms were randomised to SleepFix with a wearable device (Fitbit; n=62) or SleepFix alone (n=66). Although there was no significant impact of wearable usage on insomnia, wearable device users reported improved sleep outcomes and greater engagement with the app. Together, these studies provide a comprehensive evaluation of a mobile app for insomnia and provides evidence for its feasibility and effectiveness.
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See moreThe aim of this thesis was to design, implement and evaluate a new mobile behavioural sleep therapy application for insomnia (SleepFix®). The rationale behind this research is the high prevalence rates of insomnia and a lack of trained clinicians to provide face-to-face psychological therapy. The first study used a mixed-methods approach to understand the user needs and preferences of individuals with insomnia. Several design requirements were considered important for engagement by end-users, such as the inclusion of sleep tracking, alarms and personalised features. The next study was a systematic review critically assessing evidence for the design, implementation and evaluation of mobile apps for insomnia. Only 15 papers describing a total of 8 apps were identified. The majority of these papers described the design and implementation. There were very few papers evaluating efficacy with only one adequately powered randomised controlled trial (RCT), stressing the need for further evidence-based apps. To assess the implementation outcomes of SleepFix, a pilot feasibility study was conducted showing the app was highly engaging, acceptable and potentially efficacious. Statistically significant and clinically meaningful improvements were reported in insomnia severity. The final study aimed to assess the adjunctive use of a wearable device synchronised with SleepFix enhanced outcomes. This was the first RCT to assess the effect of an integrated wearable with a mobile app for insomnia. One-hundred and twenty-eight individuals with insomnia symptoms were randomised to SleepFix with a wearable device (Fitbit; n=62) or SleepFix alone (n=66). Although there was no significant impact of wearable usage on insomnia, wearable device users reported improved sleep outcomes and greater engagement with the app. Together, these studies provide a comprehensive evaluation of a mobile app for insomnia and provides evidence for its feasibility and effectiveness.
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Date
2020Rights statement
The author retains copyright of this thesis. It may only be used for the purposes of research and study. It must not be used for any other purposes and may not be transmitted or shared with others without prior permission.Faculty/School
Faculty of Medicine and Health, Sydney Medical SchoolAwarding institution
The University of SydneyShare