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Mind, Body and Machine: Preliminary Study to Explore Predictors of Treatment Response After a Sleep Robot Intervention for Adults with Insomnia
Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).ORCID iD: 0000-0001-5749-0774
Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).ORCID iD: 0000-0002-9688-5805
Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).ORCID iD: 0000-0001-8102-8168
Linköping University Hospital, Sweden; Linköping University, Sweden.
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2023 (English)In: Nature and Science of Sleep, ISSN 1179-1608, Vol. 15, p. 567-577Article in journal (Refereed) Published
Abstract [en]

Introduction: The study aimed to explore characteristics of responders to a sleep robot intervention for adults with insomnia, and the likelihood that participants responded to the intervention. Methods: Data from the intervention and the control group in a randomized waitlist-controlled trial (n = 44) were pooled together after both had undergone the intervention. A repeated measures ANOVA and Friedman tests were used to explore changes over time. Differences in baseline characteristics between responders (n = 13), defined as a reduction of -5 on the Insomnia Severity Index from pre- to post-intervention, and non-responders (n = 31) were analyzed with t-tests and chi-square tests. Finally, logistic regression models were estimated.Results: Baseline anxiety was the only statistically significant difference between responders and non-responders (p = 0.03). A logistic regression model with anxiety and sleep quality as predictors was statistically significant, correctly classifying 83.3% of cases. Discussion: The results imply that people with lower anxiety and higher sleep quality at baseline are more likely to report clinically significant improvements in insomnia from the sleep robot intervention.

Place, publisher, year, edition, pages
Dove Medical Press, 2023. Vol. 15, p. 567-577
Keywords [en]
anxiety, depression, insomnia, sleep, sleep diary, sleep robot, treatment response
National Category
Public Health, Global Health, Social Medicine and Epidemiology Nursing
Research subject
Psychology
Identifiers
URN: urn:nbn:se:kau:diva-96322DOI: 10.2147/NSS.S408714ISI: 001031039800001PubMedID: 37465662Scopus ID: 2-s2.0-85170092331OAI: oai:DiVA.org:kau-96322DiVA, id: diva2:1786876
Available from: 2023-08-10 Created: 2023-08-10 Last updated: 2023-10-12Bibliographically approved
In thesis
1. Lean, mean sleep machine?: Effects and experiences of a sleep robot intervention for adults with insomnia
Open this publication in new window or tab >>Lean, mean sleep machine?: Effects and experiences of a sleep robot intervention for adults with insomnia
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Many adults suffer from insomnia disorder, struggling to fall asleep, stay asleep, or with early morning awakenings. Hyperarousal is an important predisposing, precipitating and perpetuating factor to insomnia. Anxiety, depression and ADHD are common comorbid disorders, with shared cognitive, behavioral, genetic, and neurological features. Cognitive Behavioral Therapy for insomnia (CBT-I) is the gold-standard treatment, more effective and economical than pharmacological treatments, though not suitable or available for everyone. Unfortunately, sleeping pills are still more common than CBT-I, despite known risks. One potential treatment avenue is consumer sleep technology, including interventional sleep robots. 

This thesis aimed to assess the safety, acceptability, effects, and experiences of a commercial sleep robot for insomnia in adults. Overall, the thesis does not strongly support the sleep robot as an effective insomnia treatment. The intervention might not have addressed important precipitating factors of the participants’ insomnia, and the robot’s impact on stress reactivity and other potentially important factors remain uncertain. Until more robust research studies are conducted, the current sleep robot intervention should not be considered an evidence-based treatment for adults with insomnia.

Abstract [en]

Many adults suffer from insomnia disorder, which entails a difficulty initiating sleep and maintaining sleep, or undesired early morning awakenings coupled with trouble going back to sleep. Hyperarousal is an important causal and maintaining factor in insomnia. Furthermore, comorbid conditions such as anxiety, depression, and ADHD are common. The first line treatment of insomnia is Cognitive Behavioral Therapy, which has been found to be more effective and economical than pharmaceuticals, albeit not suitable or available for all. Sleeping pills are still the most common treatments of insomnia, which is unfortunate due to established risks. Thus, research on credible treatment options is warranted. One potential type of treatment is consumer sleep technology. The current thesis aimed to assess the safety, acceptability, effects, and experiences of the Somnox sleep robot in adults with insomnia.

Overall, the findings from the studies included in the thesis were not strongly in support of the Somnox sleep robot effectively alleviating symptoms of insomnia in adults. To further improve the understanding of the efficiency of technological devices in reducing arousal, future studies could investigate their impact on stress reactivity levels in participants (as opposed to a generalized hyperarousal), with or without prior stress inducement. There is a lack of empirical evidence on whether relaxation techniques actually improve participants’ sleep. It is also possible that the robot could improve sleep through means other than reducing arousal (e.g., stimulus control). Additionally, without measuring participants’ breathing, it is unclear if potentially reduced arousal is due to more adaptive breathing. Nonetheless, it is important to assess first whether the intervention has any effects at all. Until there is substantial evidence from more studies that demonstrate its efficacy, the Somnox sleep robot should not be considered an evidence-based treatment of insomnia.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2024. p. 85
Series
Karlstad University Studies, ISSN 1403-8099 ; 2023:29
Keywords
ADHD, anxiety, depression, hyperarousal, insomnia, robot, sleep
National Category
Applied Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-96957 (URN)978-91-7867-406-0 (ISBN)978-91-7867-407-7 (ISBN)
Public defence
2023-01-12, 1B309 Sjöströmsalen, Universitetsgatan 2, Karlstad, 09:15 (English)
Opponent
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Available from: 2023-12-01 Created: 2023-10-11 Last updated: 2023-12-01Bibliographically approved

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Störe, Siri JakobssonTillfors, MariaWästlund, ErikNorell-Clarke, Annika

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