0427 Real-Time Monitoring of Sleep-Wake Status and Thought Content: Associations with Insomnia Symptom Reduction

• Published in: Sleep (New York, N.Y.) N.Y.), 2019-04, Vol.42 (Supplement_1), p.A172-A173
• Main Authors: Goodhines, Patricia A, Caicedo Bastidas, Carlos E, Rajagopala, Sanjana, Park, Aesoon, Lichstein, Kenneth L, Gellis, Les A
• Format: Article
• Language: English
• Subjects: Insomnia; Sleep
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleep/zsz067.426

Introduction The current study piloted the Sleep Experiences and Assessment Application (SEAA), a smartphone application developed for cost-effective, naturalistic, event-level assessment of pre-sleep experiences. The SEAA delivers audible prompts immediately before sleep and throughout the sleep period, which users respond to by verbally recording their wake status and thought content in the moment. The current study aimed to investigate effects of SEAA usage on subjective sleep experiences among individuals with and without insomnia. Methods Data were obtained from a 3-week daily investigation of 19 community participants (mean age=21.74 [SD=5.21, range: 18-40], 37% male, 58% White; 63% with Insomnia Disorder). Daily online sleep diaries were administered for 3 weeks to assess subjective sleep behaviors and experiences. Participants utilized the SEAA each night during week 2 of the study. The Insomnia Severity Index (ISI) was administered at baseline and follow-up after three weeks. Results Mixed ANOVA analyses were conducted with alpha set at .10 due to the exploratory nature and small sample of this pilot study. Results demonstrated large, significant group by time interaction effects on global insomnia severity (F(1,15)=4.21, p=.058, ηp2=.22) and average daily sleep efficiency (F(1,15)=3.95, p=.07, ηp2=.21). Specifically, compared to the non-insomnia group, the insomnia group endorsed a greater reduction in ISI scores from baseline to follow-up and a greater improvement in daily average sleep efficiency from Week 1 to Week 3. Qualitative feedback at follow-up showed that individuals with insomnia reported: (a) a better subjective estimate of sleep onset latency and number of nighttime awakenings; (b) becoming more aware of pre-sleep thought content that inhibits sleep. Conclusion These preliminary findings suggest that real time monitoring of pre-sleep thoughts and sleep status using the SEAA may be associated with improved sleep among individuals with insomnia. Observed insomnia symptom reduction may be explained by improved estimation of sleep patterns and increased awareness of maladaptive pre-sleep thought content. Findings highlight the potential benefits of real-time monitoring of the pre-sleep experiences using the SEAA. Support (If Any) Syracuse University Internal Grant awarded to Les A. Gellis.