Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan.
Research Center for Child Mental Development, University of Fukui, Yoshida-gun, Fukui, Japan.
JMIR Mhealth Uhealth. 2023 Feb 10;11:e40836. doi: 10.2196/40836.
Sleep problems are quite common among young children and are often a challenge for parents and a hinderance to children's development. Although behavioral therapy has proven effective in reducing sleep problems in children, a lack of access to professionals who can provide effective support is a major barrier for many caregivers. Therefore, pediatric sleep experts have begun developing apps and web-based services for caregivers. Despite the substantial influence of cultural and familial factors on children's sleep, little effort has gone into developing cultural or family-tailored interventions.
This study aimed to examine the effectiveness of the interactive smartphone app "Nenne Navi," which provides culturally and family-tailored suggestions for improving sleep habits in young Japanese children through community-based long-term trials. The study also aimed to investigate the association between app-driven improvements in sleep and mental development in children.
This study adopted a community-based approach to recruit individuals from the Higashi-Osaka city (Japan) who met ≥1 of the following eligibility criteria for sleep problems: sleeping after 10 PM, getting <9 hours of nighttime sleep, and experiencing frequent nighttime awakenings. A total of 87 Japanese caregivers with young children (mean 19.50, SD 0.70 months) were recruited and assigned to the app use group (intervention group) or the video-only group (control group). Both groups received educational video content regarding sleep health literacy. The caregivers in the intervention group used the app, which provides family-tailored suggestions, once per month for 1 year.
A total of 92% (33/36) of the caregivers in the app use group completed 1 year of the intervention. The participants' overall evaluation of the app was positive. The wake-up time was advanced (base mean 8:06 AM; post mean 7:48 AM; F=6.769; P=.01 and sleep onset latency was decreased (base mean 34.45 minutes; post mean 20.05 minutes; F=23.219; P<.001) significantly in the app use group at the 13th month compared with the video-only group. Moreover, multiple regression analysis showed that decreased social jetlag (β=-0.302; P=.03) and increased sleep onset latency SD (β=.426; P=.02) in children predicted a significant enhancement in the development of social relationships with adults. At 6 months after the completion of the app use, all the caregivers reported continuation of the new lifestyle.
The present findings suggest that the app "Nenne Navi" has high continuity in community use and can improve sleep habits in young Japanese children and that interventions for sleep habits of young children may lead to the enhancement of children's social development. Future studies must focus on the effectiveness of the app in other regions with different regional characteristics and neuroscientific investigations on how changes in sleep impact brain development.
睡眠问题在幼儿中很常见，这对父母来说是一个挑战，也阻碍了孩子的发展。尽管行为疗法已被证明能有效减少儿童的睡眠问题，但许多照顾者由于缺乏能够提供有效支持的专业人员，而面临着巨大的障碍。因此，儿科睡眠专家已经开始为照顾者开发应用程序和基于网络的服务。尽管文化和家庭因素对儿童睡眠有很大影响，但在开发针对文化或家庭的干预措施方面却鲜有尝试。
本研究旨在通过基于社区的长期试验，检验互动智能手机应用程序“Nenne Navi”的有效性，该应用程序通过提供针对年轻日本儿童的文化和家庭定制建议，改善他们的睡眠习惯。本研究还旨在调查应用程序驱动的睡眠改善与儿童心理发展之间的关联。
本研究采用基于社区的方法，从大阪东区（日本）招募符合以下睡眠问题标准之一的个体：晚上 10 点以后睡觉、夜间睡眠时间少于 9 小时、夜间频繁醒来。共招募了 87 名有幼儿的日本照顾者（平均年龄 19.50 岁，标准差 0.70 个月），并将他们分为使用应用程序组（干预组）或仅观看视频组（对照组）。两组均接受了有关睡眠健康素养的教育视频内容。干预组的照顾者每月使用一次该应用程序，为期 1 年，该应用程序提供家庭定制建议。
共有 92%（33/36）的应用程序使用组的照顾者完成了 1 年的干预。参与者对该应用程序的整体评价是积极的。与仅观看视频组相比，干预组在第 13 个月时，儿童的起床时间提前（基础均值 8:06 AM；后测均值 7:48 AM；F=6.769；P=.01），入睡潜伏期缩短（基础均值 34.45 分钟；后测均值 20.05 分钟；F=23.219；P<.001）。此外，多元回归分析表明，儿童的社会时差减少（β=-0.302；P=.03）和入睡潜伏期标准差增加（β=.426；P=.02）可以显著提高与成人的社会关系发展。在使用应用程序结束后的 6 个月，所有的照顾者都报告了新的生活方式的持续。
本研究结果表明，应用程序“Nenne Navi”在社区中具有较高的使用连续性，可改善日本幼儿的睡眠习惯，而针对幼儿睡眠习惯的干预措施可能会促进儿童社会发展。未来的研究必须关注该应用程序在具有不同区域特征的其他地区的有效性，以及关于睡眠变化如何影响大脑发育的神经科学研究。
