Experience with the use of a digital sleep diary in symptom management by individuals with insomnia -a pilot mixed method study

Thea Christine Thorshov; Caroline Tonje Øverby; Diana Dobran Hansen; Way Kiat Bong; Knut Skifjeld; Petter Hurlen; Toril Dammen; Anne Moen; Harald Hrubos-Strøm

doi:10.1016/j.sleepx.2023.100093

Experience with the use of a digital sleep diary in symptom management by individuals with insomnia -a pilot mixed method study

Sleep Med X. 2023 Nov 14:6:100093. doi: 10.1016/j.sleepx.2023.100093. eCollection 2023 Dec 15.

Authors

Thea Christine Thorshov^{1

2}, Caroline Tonje Øverby^{1

3}, Diana Dobran Hansen^{1

2}, Way Kiat Bong⁴, Knut Skifjeld⁵, Petter Hurlen⁶, Toril Dammen^{2

7}, Anne Moen⁸, Harald Hrubos-Strøm^{1

3}

Affiliations

¹ Division of Surgery, Department of Otorhinolaryngology, Akershus University Hospital, Lørenskog, Norway.
² Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Norway.
³ Faculty of Medicine, Institute of Clinical Medicine, Campus Ahus, University of Oslo, Norway.
⁴ Faculty of Technology, Art and Design, Department of Computer Science, Human-Computer Interaction and Universal Design of ICT, Oslo Metropolitan University, Oslo, Norway.
⁵ Norsk e-helse, Oslo, Norway.
⁶ Division of Clinical Informatics, Department of Diagnostics and Technology, Akershus University Hospital, Lørenskog, Norway.
⁷ Department of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
⁸ Faculty of Medicine, Institute of Health and Society, Department of Nursing Science, University of Oslo, Norway.

Abstract

Background: Insomnia is the most common sleep disorder. The recommended treatment is cognitive behavioural therapy for insomnia (CBTi). A sleep diary is a core tool in CBTi. We have developed a digital sleep diary with a standardised feedback function.

Aim: To study feasibility of the digital sleep diary in participants of the Akershus Sleep Apnea (ASAP) cohorts with difficulties falling asleep or maintaining sleep. To describe sleep diary engagement and explore experiences with the digital sleep diary with potential influences in insomnia symptom management.

Material and methods: Twenty participants were recruited from the ASAP. All filled out a digital sleep diary up to 12 weeks. Treatment options provided were a self-help book (N = 11) or electroencephalography neurofeedback (N = 9) in addition to the sleep diary standardised feedback function. We collected quantitative data from the sleep diary reports and we sub-divided insomnia by sleep onset insomnia and non-sleep onset insomnia. Finally, we performed qualitative interviews.

Results: The median number of entries to the sleep diary was 81 (25th quartile: 26, 75th quartile 84). In the qualitative analysis, we identified two main themes; "structure and overview" and "usability and digital features".

Conclusion: The sleep diary was found to be feasible when distributed in combination with a self-help book or electroencephalography neurofeedback. The qualitative results emphasised the importance of a timely graphical overview and visualisations of self-recorded sleep.

Keywords: Digital sleep diary; Engagement; Feasibility; Insomnia; Motivation; Patient-reported outcomes; Self-management.