Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan.
Department of Psychosomatic Medicine, Toho University School of Medicine, 5-21-16 Omorinishi, Ota, Tokyo, 143-8540, Japan.
Sleep Med. 2024 Jul;119:357-364. doi: 10.1016/j.sleep.2024.05.020. Epub 2024 May 9.
OBJECTIVE/BACKGROUND: To clarify whether mobile sleep applications alleviate insomnia symptoms among adults from multi-community.
PATIENTS/METHODS: A literature search was conducted using the PubMed, Cochrane, PsycINFO, and Web of Science databases for articles related to mobile technology and sleep interventions published between database inceptions and March 27, 2023. We pooled relevant data using a random-effects model, and a meta-analysis was performed using a web version of the Cochrane Review Manager. The effect size was estimated and reported as the combined overall effect (weighted average). Forest plots were created, and the Cochrane risk-of-bias tool and Newcastle-Ottawa Scale were used to evaluate studies.
After an initial screening and full-text reviews, seven studies were identified with a total of 10,139 participants (females n = 8844, 87.2 %) recruited from multi-community and not diagnosed with sleep disorders or taking medications. These studies included one cross-sectional study investigating mindfulness meditation apps and six randomized-controlled trials (RCTs), including one with sleep-feedback messaging, one comparing sleep applications with or without a wearable device, and four with multicomponent interventions based on cognitive theory and subsequent behavioral change techniques. In a meta-analysis of three cognitive behavior therapy (CBT)-based RCTs, the intervention group showed statistically significant improvements in insomnia symptoms according to the Pittsburgh Sleep Quality Index but with high heterogeneity, while two CBT-based RCTs showed no significant improvements in the Insomnia Severity Index with low heterogeneity.
A small body of evidence supports the use of CBT-based sleep applications to improve insomnia symptoms among adults from multi-community.
目的/背景：明确移动睡眠应用程序是否能减轻多社区成年人的失眠症状。
患者/方法：使用 PubMed、Cochrane、PsycINFO 和 Web of Science 数据库对从数据库创建到 2023 年 3 月 27 日期间发表的与移动技术和睡眠干预相关的文章进行文献检索。我们使用随机效应模型汇总相关数据，并使用 Cochrane Review Manager 的网络版本进行荟萃分析。估计并报告了合并的总体效应（加权平均值）作为效应量。创建了森林图，并使用 Cochrane 偏倚风险工具和 Newcastle-Ottawa 量表评估研究。
经过初步筛选和全文审查，确定了 7 项研究，共有 10139 名参与者（女性 n=8844，87.2%）来自多社区，未被诊断为睡眠障碍或服用药物。这些研究包括一项关于正念冥想应用程序的横断面研究和六项随机对照试验（RCT），其中一项涉及睡眠反馈信息传递，一项比较了具有或不具有可穿戴设备的睡眠应用程序，四项基于认知理论和随后的行为改变技术的多成分干预。在对三项基于认知行为疗法（CBT）的 RCT 的荟萃分析中，干预组在匹兹堡睡眠质量指数上显示失眠症状有统计学意义的改善，但存在高度异质性，而两项基于 CBT 的 RCT 在异质性低的情况下，在失眠严重程度指数上没有显示出显著的改善。
少量证据支持使用基于 CBT 的睡眠应用程序来改善多社区成年人的失眠症状。
