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基于智能手机的虚拟伴侣治疗普通人群失眠症的疗效:睡眠日记监测与互联网自主干预对比

Efficacy of a Smartphone-Based Virtual Companion to Treat Insomniac Complaints in the General Population: Sleep Diary Monitoring Versus an Internet Autonomous Intervention.

作者信息

Philip Pierre, Dupuy Lucile, Sagaspe Patricia, de Sevin Etienne, Auriacombe Marc, Taillard Jacques, Micoulaud-Franchi Jean-Arthur, Morin Charles M

机构信息

SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France.

CNRS, SANPSY, UMR 6033, F-33000 Bordeaux, France.

出版信息

J Clin Med. 2022 Jul 28;11(15):4387. doi: 10.3390/jcm11154387.


DOI:10.3390/jcm11154387
PMID:35956005
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9368919/
Abstract

(1) Background: Insomnia is the most prevalent sleep disorder worldwide and cognitive behavioral therapy is the front-line treatment. Digital health technologies have a role to play in screening and delivering interventions remotely and without the need for human intervention. The KANOPEE app, which provides a screening and behavioral intervention for insomnia symptoms through an interaction with a virtual agent, showed encouraging results in previous studies during and after the COVID-19 lockdown, but has not yet been evaluated in a controlled study. This study aims at comparing the benefits of KANOPEE, a smartphone application dealing with insomnia complaints, with another application proposing an electronic sleep diary named “My Sleep Diary”. The acceptance and potential benefits of these digital solutions are tested in real-life settings (i.e., without soliciting human medical resources) and in the general population. (2) Methods: Subjects were included if they downloaded one of the apps between December 2020 and October 2021, and were of legal age. Both apps were available on downloading platforms in France. Primary outcome was Insomnia Severity Index (ISI), and secondary outcomes were total sleep time (TST), sleep efficiency (SE) and wake time after sleep onset (WASO). (3) Results: A total of 535 users completed the intervention with KANOPEE and 489 users completed My Sleep Diary, both for 17 days. KANOPEE users improved their ISI score significantly more than sleep diary users (interaction Time*Group: F(2,2002) = 17.3, p < 0.001). Similar results were found for nocturnal sleep parameters (TST) (KANOPEE users gained 48 min of sleep after intervention, while My Sleep Diary users gained only 16 min of sleep), and particularly in the population with moderate to severe initial sleep complaints (F(4,1980) = 8.9, p < 0.001). Other sleep markers (SE and WASO) were significantly improved in the KANOPEE users compared to the sleep diary ones (p < 0.001). (4) Conclusions: KANOPEE provides significantly greater benefits than an electronic sleep diary regarding reduction of insomnia complaints and estimated nocturnal sleep characteristics in a self-selected sample of the general population. Population with the most severe initial ISI score (≥15) benefited the most from the KANOPEE App compared to filling up a simple sleep diary.

摘要

(1) 背景:失眠是全球最普遍的睡眠障碍,认知行为疗法是一线治疗方法。数字健康技术在远程筛查和提供干预措施方面发挥着作用,且无需人工干预。KANOPEE应用程序通过与虚拟代理交互为失眠症状提供筛查和行为干预,在先前关于新冠疫情封锁期间及之后的研究中显示出令人鼓舞的结果,但尚未在对照研究中进行评估。本研究旨在比较处理失眠问题的智能手机应用程序KANOPEE与另一个提供名为“My Sleep Diary”电子睡眠日记的应用程序的益处。这些数字解决方案的可接受性和潜在益处将在现实生活环境(即不寻求人力医疗资源)和普通人群中进行测试。(2) 方法:如果受试者在2020年12月至2021年10月期间下载了其中一款应用程序且达到法定年龄,则纳入研究。两款应用程序均可在法国的下载平台上获取。主要结局指标是失眠严重程度指数(ISI),次要结局指标是总睡眠时间(TST)、睡眠效率(SE)和睡眠开始后觉醒时间(WASO)。(3) 结果:共有535名用户完成了KANOPEE干预,489名用户完成了“My Sleep Diary”干预,均为期17天。KANOPEE用户的ISI评分改善幅度明显大于睡眠日记用户(时间*组间交互作用:F(2,2002) = 17.3,p < 0.001)。夜间睡眠参数(TST)也有类似结果(KANOPEE用户干预后睡眠时间增加了48分钟,而“My Sleep Diary”用户仅增加了16分钟睡眠),尤其是在初始睡眠问题为中度至重度的人群中(F(4,1980) = 8.9,p < 0.001)。与睡眠日记用户相比,KANOPEE用户的其他睡眠指标(SE和WASO)也有显著改善(p < 0.001)。(4) 结论:在普通人群的自我选择样本中,就减少失眠问题和估计夜间睡眠特征而言,KANOPEE比电子睡眠日记提供的益处显著更大。与填写简单睡眠日记相比,初始ISI评分最高(≥15)的人群从KANOPEE应用程序中获益最大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8157/9368919/f46f501b1340/jcm-11-04387-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8157/9368919/e10eb175d698/jcm-11-04387-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8157/9368919/9a3e23fa1f32/jcm-11-04387-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8157/9368919/72b7d650a405/jcm-11-04387-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8157/9368919/f46f501b1340/jcm-11-04387-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8157/9368919/e10eb175d698/jcm-11-04387-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8157/9368919/9a3e23fa1f32/jcm-11-04387-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8157/9368919/72b7d650a405/jcm-11-04387-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8157/9368919/f46f501b1340/jcm-11-04387-g004.jpg

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[3]
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[5]
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[6]
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本文引用的文献

[1]
Association of Self-reported COVID-19 Infection and SARS-CoV-2 Serology Test Results With Persistent Physical Symptoms Among French Adults During the COVID-19 Pandemic.

JAMA Intern Med. 2022-1-1

[2]
Smartphone-based virtual agents and insomnia management: A proof-of-concept study for new methods of autonomous screening and management of insomnia symptoms in the general population.

J Sleep Res. 2022-4

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Smartphone-Based Virtual Agents to Help Individuals With Sleep Concerns During COVID-19 Confinement: Feasibility Study.

J Med Internet Res. 2020-12-18

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