Cognitive Behavioral Therapy Using a Mobile Application Synchronizable With Wearable Devices for Insomnia Treatment: A Pilot Study.
OBJECTIVE
The use of telemedicine with a mobile application (MA) and a wearable device (WD) for the management of sleep disorders has recently received considerable attention. We designed an MA synchronizable with a WD for insomnia treatment. Our pilot study determined the efficacy of simplified group cognitive behavioral therapy for insomnia (CBT-I) delivered using our MA and assessed participant adherence to and satisfaction with the device.


METHODS
The efficacy of the CBT-I using MA (CBT-I-MA) was assessed by comparing sleep variables (sleep efficiency [SE], Insomnia Severity Index [ISI], and Pittsburgh Sleep Quality Inventory [PSQI] scores) before and after a 4-week treatment protocol in 19 patients with insomnia disorder patients. SE was assessed using a sleep diary, actigraphy, and the PSQI.


RESULTS
The intervention significantly improved all three measures of SE (P< .05), and the response rate to treatment was high (94.7%). Total ISI and PSQI scores and sleep latency, as measured by the sleep diary, improved significantly. Participants showed relatively good adherence to our MA, and sleep diary entries were made on 24.3 ± 3.8 of 28 days. Moreover, 94.7% of the participants reported that our MA was effective for treating insomnia.


CONCLUSIONS
Our pilot study suggested the clinical usefulness of a CBT-I-MA. We expect that our findings will lead to further development and replication studies of CBT-I-MA.
Department of Psychiatry, Gil Medical Center, Gachon University, School of Medicine, Incheon, Republic of Korea.
Seung-Gul
SG
Kang
Department of Psychiatry, Gil Medical Center, Gachon University, School of Medicine, Incheon, Republic of Korea.
Jae Myeong
JM
Kang
Department of Psychiatry, Gil Medical Center, Gachon University, School of Medicine, Incheon, Republic of Korea.
Seong-Jin
SJ
Cho
Department of Preventive Medicine, Gachon University School of Medicine, Incheon, Republic of Korea.
Kwang-Pil
KP
Ko
Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
Yu Jin
YJ
Lee
Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea.
Heon-Jeong
HJ
Lee
Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea.
Leen
L
Kim
Departments of Psychiatry and Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
John W
JW
Winkelman
D056044:Actigraphy; D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D010349:Patient Compliance / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010865:Pilot Projects; D007319:Sleep Initiation and Maintenance Disorders / Q000628:therapy*; D017216:Telemedicine / Q000379:methods*; D016896:Treatment Outcome; D000076251:Wearable Electronic Devices
cognitive behavioral therapy; insomnia; mobile application; telemedicine; wearable device