Pilot evaluation of the Sleep Ninja: a smartphone application for adolescent insomnia symptoms

BMJ Open. 2019 May 27;9(5):e026502. doi: 10.1136/bmjopen-2018-026502.

Abstract

Objectives: The aim of this study was to test the feasibility, acceptability and preliminary effects of a recently developed smartphone application, Sleep Ninja, for adolescent sleep difficulties.

Setting: The study was conducted online with Australian individuals recruited through the community.

Participants: Participants were 50 young people aged 12-16 years with sleep difficulties.

Design: A single-arm pre-post design was used to evaluate feasibility, acceptability and sleep and mental health variables at baseline and postintervention.

Intervention: Cognitive-behavioural therapy for insomnia informed the development of the Sleep Ninja. The core strategies covered by the app are psychoeducation, stimulus control, sleep hygiene and sleep-related cognitive therapy. It includes six training sessions (lessons), a sleep tracking function, recommended bedtimes based on sleep guidelines, reminders to start a wind-down routine each night, a series of sleep tips and general information about sleep. Users progress through each training session and conclude the 6-week programme with a black belt in sleep.

Outcome measures: Feasibility was evaluated based on consent rates, adherence and attrition, acceptability was assessed using questionnaires and a poststudy interview, and sleep, depression and anxiety variables were assessed at baseline and postintervention.

Results: Data indicated that the Sleep Ninja is a feasible intervention and is acceptable to young people. Findings showed that there were significant improvements on sleep variables including insomnia (within-group effect size d=-0.90), sleep quality (d=-0.46), depression (d=-0.36) and anxiety (d=-0.41).

Conclusions: The Sleep Ninja is a promising intervention that could assist adolescents who experience sleep difficulties. A follow-up randomised controlled trial is now warranted.

Trial registration number: ACTRN12617000141347.

Keywords: Adolescent Mental Health; Cognitive-behaviour Therapy For Insomnia; Ehealth; Insomnia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anxiety / therapy*
  • Australia
  • Child
  • Cognitive Behavioral Therapy*
  • Depression / therapy*
  • Female
  • Humans
  • Male
  • Mental Health Services
  • Mobile Applications*
  • Patient Acceptance of Health Care
  • Pilot Projects
  • Psychiatric Status Rating Scales
  • Sleep Initiation and Maintenance Disorders / psychology
  • Sleep Initiation and Maintenance Disorders / therapy*
  • Smartphone*
  • Surveys and Questionnaires

Associated data

  • ANZCTR/ACTRN12617000141347