Sleep Apps for Youth: A Scoping Review of What is Available and What is Needed (Preprint)

Abstract

Sleep difficulties are prevalent and concerning for many North Americans. Despite strong empirical support for insomnia treatment, lack of access presents a significant barrier to treatment dissemination. This is particularly true amongst teens and young adults. Mobile applications (‘apps’) are uniquely suited to address this need.

We conducted a scoping review to identify and appraise commercially available apps for AYAs with sleep difficulties.

Proceeding in 3 phases, a comprehensive search of commercially available apps was conducted between August 2016 and January 2017. The initial phase involved a search of app stores using relevant search terms (sleep; sleeping; insomnia; sleep aid; night). In the second phase, apps were assessed for eligibility using the following inclusion criteria: 1) Goal is to provide education, tools, or advice related to management of insomnia symptoms. 2) Primary intended users are AYAs. Exclusion criteria were: 1) App is classified as an ‘e-book.’ 2) Primary utility is meditation, hypnosis, or relaxation for sleep. 3) Primary function is background sleep music or sounds. 4) Primary function is alarm clock. 5) Sole sleep aid function is tracking/monitoring, with no education, tools, or advice for insomnia. In the third phase, apps were culled for functionality information, including: A) Self-monitoring of symptoms; B) Tracking sleep; C) Education related to insomnia; D) Advice or intervention for managing insomnia symptoms. Finally, the primary investigator conducted a final review of phase 3 apps, closely examining the functionality of these apps, based on app descriptions, app content, and developer website (where available).

The initial search yielded 2036 apps; after eligibility criteria were applied, functionality information was extracted for 48 apps. Twenty-three of these were later excluded. Of the final 25 apps, 24% included self-monitoring of symptoms; 28% included a sleep tracking function; 56% provided insomnia education; and 92% provided advice or intervention for managing sleep difficulties. The majority (80%) were free. Several (20%) provided sleep interventions that are not supported by research. In the final evaluation, only 6 apps met all four of the functionality criteria; of these, none were geared towards AYA users specifically. The purported and examined functionality of these six apps are discussed.

Insomnia is a unique problem among AYAs, as non-insomnia factors must also be considered when designing an appropriate intervention (e.g., AYAs are more delayed in sleep schedule, require more sleep than adults). There are currently 6 apps that are appropriate for self-management of adult insomnia. There are 0 apps designed for AYA users. Development of an evidence-based app for managing insomnia in this population is critical. Once an appropriate app becomes available, future studies should test its usability and efficacy in AYA samples.