Impact of Sleep Hygiene Education and Sleep App on Insomnia in Adults

Abstract

Sleep remains one of the most crucial parts of an individual’s health and wellbeing. However, sleep disorders have become major health problems affecting many people across different ages in the United States. This project discusses the reduction of incidences of insomnia or sleep problems among adults using sleep hygiene education and sleep app. The purpose of the project is to describe the effects of sleep hygiene education and sleep tracking app on reduction of sleep incidences among adults aged 18 to 65 years. A pre-test and post-test experimental study was conducted on a group of 50 study participants identified through convenience sampling. Data was collected from the sample using the Pittsburgh Sleep Quality Index (PSQI) at baseline and after administering the intervention for four weeks. In a paired samples t-test comparing insomnia scores before and after 4 weeks, sleep hygiene education and sleep tracking app, adults aged 18 to 65 years should show an average reduction of about 4 points.

Keywords: sleep, sleep disorders, insomnia, sleep hygiene education, sleep app, incidences, reduction, intervention.

Reduction of Sleep Incidences with Sleep Hygiene Education and Sleep App

Sleep is an important part of one’s health and well-being since it empowers the body to refresh and recover (Suni & Troung, 2021). However, many people suffer from sleep problems or difficulties that affect their health and wellbeing. Poor quality sleep and inadequate sleep, which affect people of all ages, are linked to various factors such as mental health, sleep disorders, and medical conditions. According to Roddick & Kristeen (2020), sleep disorders are a group of conditions affecting one’s ability to have quality sleep or sleep well regularly. Sleep problems have become common in the United States as they affect many people and have far-reaching impacts. Therefore, addressing sleep problems is critical toward enhancing the health and wellbeing of many populations in the US.

Insufficient sleep and insomnia are associated with mental health problems such as the increased risk for psychiatric disorders, suicide, and as well as chronic health conditions such as diabetes, obesity, and cardiovascular disease (Lombardero et al., 2019). 35% of the total US population observed insufficient sleep and about 27% of the US adults suffer from insomnia disorder (Liu et al., 2017; Olfson et al., 2018). In the United States, insufficient sleep has an estimated economic impact of over $411 billion each year (Suni & Troung, 2021). Adolescents who do not obtain sufficient sleep may be more involved in drinking, smoking tobacco, usage of illicit drugs, and may not perform better in school (Vick et al., 2016). In the United States, more than 6,000 fatal car crashes each year are caused by drowsy driving (U.S. Centers for Disease Control and Prevention, 2021).

Adults (aged above 18 years) have many common characteristics (anxiety, depression, or work burdens) and consequences of sleep problems experienced by university students, people suffering from disease and veterans (Soleimani et al., 2016; Roddick & Kristeen, 2020; Schlarb et al., 2017). Hemodialysis patients, university students, and Veterans reduced sleep problems (insomnia) by 3 to 6 points in one hour to 6 weeks (Soleimani et al., 2016; Reilly et al., 2019; Schlarb et al., 2017). Therefore, in a paired samples t-test comparing insomnia scores before and after 4 weeks, sleep hygiene education and sleep tracking app, adults aged 18 to 65 years should show an average reduction of about 4 points. By reducing the incidences of insomnia among adults, it can reduce the risk of psychiatric disorders, suicide, and other chronic health problems such as diabetes, obesity, and cardiovascular disease (Grandner et al., 2016; Lombardero et al., 2019). Reduction in insomnia and as well as in insufficient sleep could reduce the public health burden in a safe and cost-effective manner (Bruin et al., 2016).

Purpose Statement

The purpose of this project is to describe the effects of sleep hygiene education and sleep tracking app on the reduction of sleep incidences among adults aged 18 to 65 years. To evaluate the success of this project, I ask the following research question: “How do sleep hygiene education and sleep tracking app affect incidences of insomnia in adults aged 18 to 65 years?”

Data

To address the purpose of the study, the project will be conducted in the City of Perris, California. Data will be obtained from a group of study participants aged between 18 and 65 years suffering from insomnia disorder. These individuals will be identified from clinics or facilities that provides care for sleep disorders and comorbidities. Once a suitable study sample is identified, the data collection process will involve obtained demographic information. Insomnia levels or scores will be measured prior to administering the intervention of sleep hygiene education and sleep app. The level of insomnia will also be measured after 4 weeks of administering the intervention.

Population

The target population for this project are adults aged 18 to 65 years suffering from insomnia disorders or sleep difficulties. These individuals will be recruited from healthcare facilities in the City of Perris, California that provide care for sleep disorders. The project will include both male and female participants suffering from sleep difficulties or insomnia disorders. Healthcare facilities or clinics that provide for sleep disorder patients are appropriate settings for identifying a suitable study sample for the project. By targeting these facilities, the researcher will easily identify individuals who meet inclusion criteria for participation in this project.

Sample

A sample of 50 adults will be identified from the target population to participate in this study. As previously indicated, both males and females aged 18 to 65 years suffering from insomnia disorder or sleep difficulties will be allowed to participate in this project. All participants will be recruited from relevant healthcare facilities in the City of Perris, California. The study sample will be identified using convenience sampling, which is a non-probability sampling technique in which a sample is drawn from the population that is close to hand. The sample will be drawn from a group of people in the target population that is easy to reach.

Study participants will be recruited using leaflets and electronic leaflets distributed among healthcare facilities or practitioners within a 50-km radius from the researcher. A list of potentially eligible participants will be generated based on referrals from clinic staff. Recruitment emails will be sent to these individuals followed by a telephone call within 2 weeks for screening for study eligibility. To be eligible, participants must be aged between 18 and 65 years, reported current sleep difficulty/insomnia lasting at least four weeks and marked by an ISI score of more than 10, and impaired daytime functioning. Participants will be excluded if they have sleep difficulty lasting less than four weeks and show moderate impaired daytime functioning. Figure 1 shows participant flow for the study. Most of the participants are expected to be females with a mean age of 35 years. Additionally, most of these participants are expected to be college graduates, Whites, and with a history of alcohol consumption and smoking as shown in Table 1.

Instrumentation

Data will be collected from the sample using Pittsburgh Sleep Quality Index (PSQI), which comprises questions relating to usual sleep habits. PSQI contains 19 self-rated questions and 5 questions that are rated by a roommate or bed partner. Scoring is done using the self-rated questions only since they form seven component scores. PSQI has a high test-retest reliability shown in its adequate internal consistency at Cronbach’s ? =.69 (Spira et al., 2012). Moreover, it has good validity for primary insomnia patients as it accurately differentiates individuals reporting sleep disorders from those who don’t (Backhaus et al., 2002; Spira et al., 2012).

Data Collection

The data collection process is will begin by seeking IRB approval followed by subject recruitment. Once a study sample is identified, intervention scheduling will be carried out as well as identification of potential meetings for abstract and journals for submission. Department-level demographics will then be obtained as part of the pre-intervention survey. Pre-insomnia scores or levels will be measured during the pre-intervention survey using PSQI. This will be followed by administering sleep hygiene education and a sleep app for a period of four weeks. At the end of the four weeks, post-insomnia scores or levels will be measured using PSQI. Therefore, PSQI will be utilized to obtain pre-and post-test data on insomnia levels or scores from the identified study participants.

Variables

Measures and variables in this study on the reduction of sleep incidences using sleep hygiene education and sleep app are as follows:

· Independent variables – sleep hygiene education and sleep app.

· Dependent variables – sleep insomnia levels or scores.

· Measures (insomnia levels/scores) will be obtained at baseline and after the intervention.

Research Design

The research design to be employed for this project is a pre-test and post-test design, which is an experimental study design used to evaluate changes in participants relative to an event following the introduction of an intervention. Baseline data regarding the participants’ sleep insomnia levels will be measured using PSQI before administering the intervention. The intervention will be administered for four weeks and post-test data collected at the end. The intervention, sleep hygiene education and sleep app will involve teaching participants healthy sleep habits and providing recommendations for improvement of sleep. Participants will use the sleep app will be used to track or monitor their sleep. The intervention will help participants develop appropriate sleeping patterns for improved wellbeing and functioning. Post-test data will be compared to baseline data to determine any differences. An improvement in post-test scoring will imply that the intervention is effective in reduction of sleep incidences.

Results

Post-test data is expected to demonstrate a decrease in incidences of insomnia by 4 points within four weeks of administering the intervention. The study is expected to show improvements in the first four scoring components of PSQI after administering the intervention. In essence, the scores on Subjective Sleep Quality, Sleep Latency, Sleep Duration, and Habitual Sleep Efficiency are expected to be higher than baseline data. However, the study is expected to show a decrease in the scores on Sleep Disturbances, Use of Sleeping Medication, and Daytime Dysfunction. In a paired samples t-test comparing insomnia scores before and after 4 weeks, sleep hygiene education and sleep tracking app, adults aged 18 to 65 years should show an average reduction of about 4 points.

Analysis

Out of the 63 participants who commenced the study, only 50 participants are expected to go to the end of the project. 72% (36) of the participants are females whereas 28% (14) are males. Additionally, 56% (28) have a bachelor’s degree, 24% (12) have a Master’s degree, and the remaining 20% (10) reported having some college education. 80% of participants reported having a history of alcohol consumption and smoking for a period of at least 2 years.

Paired samples t-test comparing pre-test and post-test insomnia scores showed reduction of incidences of insomnia by 4 points within 4 weeks. The difference between the global PSQI score between pre-test and post-test data is 4 points. Four of the seven PSQI components had a higher score and three had a lower score before and after the intervention respectively.

Discussion

This study sought to describe the impact of sleep hygiene education and sleep app on incidences of insomnia in adults. It showed a 4-point reduction in incidences of insomnia or sleep problems within four weeks. After the intervention, the sleeping patterns and quality of all participants improved on almost all outcome measures. Based on PSQI scores, participants reported improved sleep quality and less daytime dysfunction. Prior to treatment, participants reported sleep difficulties and impaired sleep quality evidenced in insomnia symptoms. This implies that the intervention is an effective approach for addressing sleep difficulties and incidences of insomnia among adults. Sleep hygiene education and sleep app help reduce insomnia incidences by improving participants’ knowledge on healthy sleeping patterns. Therefore, sleep disorders can be addressed through improving knowledge on healthy sleeping patterns among populations.

Conclusions

Sleep hygiene education and sleep app demonstrated a statistically significant impact on reduction of incidences of insomnia. In a paired samples t-test comparing insomnia scores before and after 4 weeks, sleep hygiene education and sleep tracking app, adults aged 18 to 65 years should show an average reduction of about 4 points. This implies that sleep hygiene education and sleep app is an effective tool for reduction of insomnia among adults.

Limitations

Regardless of its merits, this study has some limitations. First, the study employed a relatively small sample size for a quantitative research. The small sample size significantly limits the generalization of its findings. Secondly, the research design lacked a control group, which limited the ability of the researcher to compare the findings. Third, the study lacked follow-up data that could help determine the longevity of the intervention in reducing incidences of insomnia among adults.

Significance and Implications

Sleep disorders remain major health problems affecting many people across different ages in the U.S. Through its findings, the study contributes to evidence-based practice on how to prevent sleep problems in adults. A reduction in incidences of insomnia among adults is essential in lessening the risk of psychiatric disorders and other health problems. This would in turn help lessen the public health burden in a safe and effective manner.