Gao M, Roy A, Deluty A, Sharkey KM, Hoge EA, Liu T, Brewer JA. Targeting Anxiety to Improve Sleep Disturbance: A Randomized Clinical Trial of App-Based Mindfulness Training. Psychosom Med. 2022 Jun 1;84(5):632-642. doi: 10.1097/PSY.0000000000001083.
A randomized controlled trial was conducted among adults reporting worry that interfered with sleep to test a mindfulness training app. Eighty participants were randomized to treatment as usual (TAU) or TAU plus app-based mindfulness training for anxiety. The app-based intervention, Unwinding Anxiety, included 30 core modules and 8 “theme weeks” of brief mindfulness training using videos, app-initiated check-ins, guided meditations, and short mindfulness exercises. All participants were provided Fitbit devices to track their sleep time and efficiency, completed self-report sleep diaries, and received check-ins and reminders. The intervention was completed over 2 months and participants completed assessments at 1 month (during treatment), at end of treatment, and 2 months post treatment. The primary outcome was change in worry-related sleep disturbances assessed via self-report. At the end of treatment, worry-related sleep disturbance scores significantly decreased by 27% in the treatment group compared to 6% in the TAU group. There were no significant between-group differences in average total sleep time or efficiency at the end of treatment. Results demonstrated an association between mindfulness training and decreased worry-related sleep disturbance. Digital therapeutics like app-based mindfulness training show clinical efficacy in improving sleep.