The Pros and Cons of Getting Engaged in an Online Social Community Embedded Within Digital Cognitive Behavioral Therapy for Insomnia: Survey Among Users.
BACKGROUND
Sleepio is a proven digital sleep improvement program based on cognitive behavioral therapy techniques. Users have the option to join an online community that includes weekly expert discussions, peer-to-peer discussion forums, and personal message walls.


OBJECTIVE
The aim of this study was to conduct an online survey to (1) explore the reasons for deciding to engage with the Sleepio online community, (2) explore the potential benefits arising from engagement with the online community, and (3) identify and describe any problematic issues related to use of the online community.


METHODS
We developed an online survey and posted an invitation to the community discussion forum inviting users to participate. In addition, we sent an email invitation to 970 individuals who had previously or were currently working through the Sleepio program to participate in this study.


RESULTS
In total, 100 respondents (70/100, 70% female; mean age 51 years, range 26-82 years) completed the online survey. Most respondents had started Sleepio with chronic sleep problems (59/100, 59% up to 10 years; 35/100, 35% >10 years) and had actively engaged with the online community (85/100, 85%) had made a discussion or wall post). At the time of the survey, respondents had used Sleepio for a median of 12 weeks (range from 3 weeks to 2 years). We analyzed responses to the open-ended questions using thematic analysis. This analysis revealed 5 initial drivers for engagement: (1) the desire to connect with people facing similar issues, (2) seeking personalized advice, (3) curiosity, (4) being invited by other members, and (5) wanting to use all available sleep improvement tools. Advantages of engagement included access to continuous support, a reduced sense of isolation, being part of a nonjudgmental community, personalized advice, positive comparisons with others, encouragement to keep going, and altruism. We found 5 potential disadvantages: design and navigation issues, uncertain quality of user-generated content, negative comparisons with others, excessive time commitments, and data privacy concerns. Participants related their community experiences to engagement with the Sleepio program, with many stating it had supported their efforts to improve their sleep, as well as helping with adherence and commitment to the program. Despite some concerns, members regarded the Sleepio community as a valuable resource.


CONCLUSIONS
Online communities may be a useful means through which to support long-term engagement with Web-based therapy for insomnia.
Division of Rehabilitation & Ageing, School of Medicine, University of Nottingham, Nottingham, United Kingdom. neil.coulson@nottingham.ac.uk.
Neil S
http://orcid.org/0000-0001-9940-909X
NS
Coulson
Richard
http://orcid.org/0000-0002-2181-2935
R
Smedley
Sophie
http://orcid.org/0000-0001-9008-5180
S
Bostock
Simon D
http://orcid.org/0000-0002-9581-5311
SD
Kyle
Rosie
http://orcid.org/0000-0001-8693-993X
R
Gollancz
Annemarie I
http://orcid.org/0000-0001-7517-197X
AI
Luik
Peter
http://orcid.org/0000-0002-0419-2199
P
Hames
Colin A
http://orcid.org/0000-0002-1294-8734
CA
Espie
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009042:Motivation; D012657:Self-Help Groups; D007319:Sleep Initiation and Maintenance Disorders / Q000628:therapy*; D011795:Surveys and Questionnaires
cognitive behavioral therapy; discussion forum; engagement; insomnia; online community; sleep