Efficacy of an m-Health Physical Activity and Sleep Health Intervention for Adults: A Randomized Waitlist-Controlled Trial.

INTRODUCTION

Interventions that improve both physical activity and sleep quality may be more effective in improving overall health. The purpose of the Synergy Study is to test the efficacy of a mobile health combined behavior intervention targeting physical activity and sleep quality.

STUDY DESIGN

Randomized, waitlist-controlled trial.

SETTING/PARTICIPANTS: This study had an app-based delivery mode, Australia-wide. The participants were 160 adults who reported insufficient physical activity and poor sleep quality in an eligibility survey.

INTERVENTION

The intervention was a mobile app providing educational resources, goal setting, self-monitoring, and feedback strategies. It included 12 weeks of personalized support including weekly reports, tool sheets, and prompts.

MAIN OUTCOME MEASURES

Outcomes were assessed at baseline, 3 months (primary), and 6 months (secondary endpoint). Self-reported minutes of moderate-to-vigorous intensity physical activity and sleep quality were co-primary outcomes. Resistance training; sitting time; sleep hygiene; sleep timing variability; insomnia severity; daytime sleepiness; quality of life; and depression, anxiety, and stress symptoms were secondary outcomes. Data were collected between June 2017 and February 2018 and analyzed in August 2018.

RESULTS

At 3 months, between-group differences in moderate-to-vigorous intensity physical activity were not statistically significant (p=0.139). Significantly more participants in the intervention group engaged in ≥2 days/week (p=0.004) of resistance training. The intervention group reported better overall sleep quality (p=0.009), subjective sleep quality (p=0.017), sleep onset latency (p=0.013), waketime variability (p=0.018), sleep hygiene (p=0.027), insomnia severity (p=0.002), and lower stress symptoms (p=0.032) relative to waitlist controls. At 6 months, group differences were maintained for sleep hygiene (p=0.048), insomnia severity (p=0.002), and stress symptoms (p=0.006). Differences were observed for bedtime variability (p=0.023), sleepiness (p<0.001), daytime dysfunction (p=0.039), and anxiety symptoms (p=0.003) at 6 months, but not 3 months.

CONCLUSIONS

This remotely delivered intervention did not produce statistically significant between-group differences in minutes of moderate-to-vigorous intensity physical activity. Significant short-term differences in resistance training and short- and medium-term differences in sleep health in favor of the intervention were observed.

TRIAL REGISTRATION

This study is registered at anzctr.org.au ACTRN12617000376347.