Use of the Consumer-Based Meditation App Calm for Sleep Disturbances: Cross-Sectional Survey Study

Jennifer Huberty; Megan E Puzia; Linda Larkey; Michael R Irwin; Ana-Maria Vranceanu

doi:10.2196/19508

Use of the Consumer-Based Meditation App Calm for Sleep Disturbances: Cross-Sectional Survey Study

JMIR Form Res. 2020 Nov 13;4(11):e19508. doi: 10.2196/19508.

Authors

Jennifer Huberty¹, Megan E Puzia², Linda Larkey³, Michael R Irwin^{4

5

6

7}, Ana-Maria Vranceanu⁸

Affiliations

¹ College of Health Solutions, Arizona State University, Phoenix, AZ, United States.
² Behavioral Research and Analytics, LLC, Salt Lake City, UT, United States.
³ Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States.
⁴ Cousins Center for Psychoneuroimmunology, University of Calfornia, Los Angeles, Los Angeles, CA, United States.
⁵ Mindful Awareness Research Center, University of Calfornia, Los Angeles, Los Angeles, CA, United States.
⁶ Jane and Terry Semel Insitute for Neuroscience and Human Behavior, University of Calfornia, Los Angeles, Los Angeles, CA, United States.
⁷ Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of Calfornia, Los Angeles, Los Angeles, CA, United States.
⁸ Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Cambridge, MA, United States.

PMID: 33185552
PMCID: PMC7695531
DOI: 10.2196/19508

Abstract

Background: Over 30% of Americans report regular sleep disturbance, and consumers are increasingly seeking strategies to improve sleep. Self-guided mindfulness mobile apps may help individuals improve their sleep. Despite the recent proliferation of sleep content within commercially available mindfulness apps, there is little research on how consumers are using these apps for sleep.

Objective: We conducted a cross-sectional survey among subscribers to Calm, a popular, consumer-based, mindfulness-based meditation app, and described and compared how good sleepers, poor sleepers, and those with self-reported insomnia use the app for sleep.

Methods: Participants who were paying subscribers of Calm and had used a sleep component of Calm in the last 90 days were invited to complete an investigator-developed survey that included questions about sleep disturbance and the use of Calm for sleep. Based on self-reports of sleep disturbances and of insomnia diagnosis, participants were categorized as "good sleepers," "poor sleepers," or "those with insomnia diagnosis." Chi-square tests compared reasons for downloading the app and usage patterns across participants with and without sleep disturbance.

Results: There was a total of 9868 survey respondents. Approximately 10% of participants (1008/9868, 10.21%) were good sleepers, 78% were poor sleepers (7565/9868, 77.66%), and 11% reported a diagnosis of insomnia (1039/9868, 10.53%). The sample was mostly White (8185/9797, 83.55%), non-Hispanic (8929/9423, 94.76%), and female (8166/9578, 85.26%). The most common reasons for sleep disturbances were racing thoughts (7084/8604, 82.33%), followed by stress or anxiety (6307/8604, 73.30%). Poor sleepers and those with insomnia were more likely than good sleepers to have downloaded Calm to improve sleep (χ²₂=1548.8, P<.001), reduce depression or anxiety (χ²₂=15.5, P<.001), or improve overall health (χ²₂=57.6, P<.001). Respondents with insomnia used Calm most often (mean 5.417 days/week, SD 1.936), followed by poor sleepers (mean 5.043 days/week, SD 2.027; F₂=21.544, P<.001). The most common time to use Calm was while lying down to sleep (7607/9686, 78.54%), and bedtime use was more common among poor sleepers and those with insomnia (χ²₂=382.7, P<.001). Compared to good and poor sleepers, those with insomnia were more likely to use Calm after waking up at night (χ²₂=410.3, P<.001). Most participants tried to use Calm on a regular basis (5031/8597, 58.52%), but regular nighttime use was most common among those with insomnia (646/977, 66.1%), followed by poor sleepers (4040/6930, 58.30%; χ²₂=109.3, P<.001).

Conclusions: Of the paying subscribers to Calm who have used one of the sleep components, approximately 90% have sleep difficulties, and 77% started using Calm primarily for sleep. These descriptive data point to areas of focus for continued refinement of app features and content, followed by prospective trials testing efficacy of consumer-based meditation mobile apps for improving sleep.

Keywords: consumer behavior; insomnia; meditation; mental health; mindfulness; mobile apps; mobile phone.

©Jennifer Huberty, Megan E Puzia, Linda Larkey, Michael R Irwin, Ana-Maria Vranceanu. Originally published in JMIR Formative Research (http://formative.jmir.org), 13.11.2020.