Feasibility and Preliminary Effects of a Mobile App on Sleep Disturbance

Acceptability, as measured by participants' perceptions of the appropriateness of the content in the mindful meditation app

时间窗: Participants' perceptions of appropriateness are measured immediately after the the conclusion of the 8-week intervention.

Participants' perceptions of appropriateness will be measured using six items on investigator-developed survey. Items inquire about participants' perceptions regarding the app's ease of use, aesthetics and graphics, and adequacy of the instruction (all rated on 1-5 scales, with higher ratings reflecting greater perceived appropriateness), and three items about the appropriateness of the duration of daily meditations, sleep meditations, and Sleep Stories (rated on a 1-4 scale, with higher ratings reflecting greater perceived appropriateness). Average scores will be reported for each item.

Preliminary effects of the mindfulness meditation app on sleepiness, as assessed by changes in participants' pre- and post-intervention scores on the Epworth Sleepiness Scale

时间窗: The Epworth Sleepiness Scale will be completed at immediately before (i.e., baseline) and immediately after the intervention

The Epworth Sleepiness Scale is an eight-item measure of daytime sleepiness. Respondents use a four-point scale to rate the likeliness that they would doze off or fall asleep in eight situations involving activities with low levels of stimulation, relative immobility, and relaxation, based on their usual way of life in recent times. Item ratings range from 0 to 3 (0=would never doze, 3=high chance of dozing). Items are summed to calculate a total score, ranging from 0 to 24, with higher scores indicating greater sleepiness.

Preliminary effects of the mindfulness meditation app on sleep disturbance, as assessed by changes in the frequency of participants' nightly mid-sleep awakenings over the course of the 8-week intervention period

时间窗: Sleep diaries are completed daily throughout the 8-week intervention. Each morning, participants report on the previous night's sleep. Participants submit their daily diary entries at the end of each week.

The frequency of mid-sleep awakenings will be measured by participants' self-reports in their daily sleep diaries.

Acceptability, as measured by participants' satisfaction with the content in the mindful meditation app

时间窗: Participant satisfaction is measured immediately after the the conclusion of the 8-week intervention.

Participants' satisfaction will be measured by participant responses to the item, "On a scale of 1-5 (1=did not enjoy at all, 5=very much enjoyed), how would you rate your overall enjoyment with using Calm (i.e., likeable, pleasurable)?" on an investigator-developed survey. Participants rate their satisfaction on a five-point scale, ranging from 1 (did not enjoy at all) to 5 (very much enjoyed).

Demand, as assessed by the the comparative frequency of participants use of meditation, sleep meditation, and Sleep Stories

时间窗: Frequency of use app use is recorded continuously throughout the 8-week intervention.

The frequency of using individual app components will be recorded by Calm (internally) and shared with Arizona State University.

Demand, as assessed by the the comparative duration of participants use of meditation, sleep meditation, and Sleep Stories

时间窗: Duration use app use is recorded continuously throughout the 8-week intervention.

The amount of time that participants use the app individual app components will be recorded by Calm (internally) and shared with Arizona State University.

Preliminary effects of the mindfulness meditation app on sleep disturbance, as assessed by changes in the amount of time required for participants' to fall asleep over the course of the 8-week intervention period

时间窗: Sleep diaries are completed daily throughout the 8-week intervention. Each morning, participants report on the previous night's sleep. Participants submit their daily diary entries at the end of each week.

The amount of time required to fall asleep will be measured by participants' self-reports in their daily sleep diaries.

Demand, as assessed by the percentage of participants who use the mindful meditation app for the 70% of the prescribed weekly minutes (≥ 70 minutes/week)

时间窗: Duration use app use is recorded continuously throughout the 8-week intervention.

The amount of time that participants use the app will be recorded by Calm (internally) and shared with Arizona State University.

Preliminary effects of the mindfulness meditation app on sleep disturbance, as assessed by changes in participants' nightly sleep duration over the course of the 8-week intervention period

时间窗: Sleep diaries are completed daily throughout the 8-week intervention. Each morning, participants report on the previous night's sleep. Participants submit their daily diary entries at the end of each week.

Sleep duration will be calculated using participants' reports of the time they fell asleep at night, the time that they woke up in the morning, and the amount time spent awake after waking up during the night. These times are self-reported in a gold-standard daily sleep diary.

Preliminary effects of the mindfulness meditation app on sleep disturbance, as assessed by changes in participants rating of sleep quality over the course of the 8-week intervention period

时间窗: Sleep diaries are completed daily throughout the 8-week intervention. Each morning, participants report on the previous night's sleep. Participants submit their daily diary entries at the end of each week.

Sleep quality will be measured by participants' responses to the question, "How would you rate the quality of your sleep? (1= very poor and 5= very good)," which is included in participants' daily sleep diaries.

Preliminary effects of the mindfulness meditation app on sleep disturbance, as assessed by changes in participants' pre- and post-intervention scores on the Cognitive and Somatic Arousal subscales of the Pre-Sleep Arousal Scale

时间窗: The Pre-Sleep Arousal Scale will be completed at immediately before (i.e., baseline) and immediately after the intervention

The Pre-Sleep Arousal Scale is a 16-item self-report questionnaire that measures arousal before sleep. Items describe symptoms of cognitive and somatic arousal. Using a five-point scale (1, not at all; 2, slightly: 3, moderately; 4, a lot; 5, extremely), participants rate extent to which they generally experience each symptom as they attempt to fall asleep. The Pre-Sleep Arousal Scale is comprised of two eight-item subscales, which assess Cognitive Somatic arousal. Subscale scores are determined by summing ratings from the included items. Possible scores on each subscale range from 8 to 40, with higher scores indicating greater pre-sleep arousal.

Preliminary effects of the mindfulness meditation app on sleep fatigue, as assessed by changes in participants' pre- and post-intervention scores on the Fatigue Severity Scale

时间窗: The Fatigue Severity Scale will be completed at immediately before (i.e., baseline) and immediately after the intervention

The Fatigue Severity Scale is a nine-item self-report measure of fatigue and the extent to which fatigue interferes with daily living. Respondents rate the extent to which they agree with statements about their experience with fatigue during the past week. Items are scored on a seven-point scale ranging from 1 to 7 (1=strongly disagree, 7=strongly agree). Total scores range from 1 to 7, reflecting the mean rating of the items. Higher scores indicate greater fatigue.

Preliminary effects of the mindfulness meditation app on sleep disturbance, as assessed by changes in the amount of time spent awake after mid-sleep awakenings over the course of the 8-week intervention period

时间窗: Sleep diaries are completed daily throughout the 8-week intervention. Each morning, participants report on the previous night's sleep. Participants submit their daily diary entries at the end of each week.

The amount of time spent awake after mid-sleep awakenings will be measured by participants' self-reports in their daily sleep diaries.