Smartphone applications for sleep tracking: rating and perceptions about behavioral change among users

Reema A. Karasneh; Sayer I. Al-Azzam; Karem H. Alzoubi; Sahar Hawamdeh; Anan S. Jarab; Mohammad B. Nusair

doi:10.5935/1984-0063.20210007

Sleep Science, Table of Contents

CC BY-NC-ND 4.0 · Sleep Sci 2022; 15(S 01): 65-73
DOI: 10.5935/1984-0063.20210007

ORIGINAL ARTICLE

Smartphone applications for sleep tracking: rating and perceptions about behavioral change among users

Authors

Reema A. Karasneh

¹Yarmouk University, Department of Basic Medical Sciences - Irbid - Jordan.
Sayer I. Al-Azzam

²Jordan University of Science and Technology, Department of Clinical Pharmacy - Irbid - Jordan.
Karem H. Alzoubi

²Jordan University of Science and Technology, Department of Clinical Pharmacy - Irbid - Jordan.

³University of Sharjah, Department of Pharmacy Practice and Pharmcotherapeutics - Sharjah - UAE.
Sahar Hawamdeh

²Jordan University of Science and Technology, Department of Clinical Pharmacy - Irbid - Jordan.
Anan S. Jarab

²Jordan University of Science and Technology, Department of Clinical Pharmacy - Irbid - Jordan.
Mohammad B. Nusair

⁴Yarmouk University, Department of Pharmacy Practice - Irbid - Jordan.

Abstract

Introduction This study aims to assess existing sleep apps for mobile phones to determine the perceived effect of these applications on user’s attitudes, knowledge, willingness to change, and its likelihood to change behavior from a user’s perspective.

Material and Methods A systematic search was conducted through Google play store and iTunes Apple store using terms related to sleep tracking. Apps were evaluated using Mobile Application Rating Scale (MARS) tool for assessing and classifying mobile health applications quality. Additionally, a convenience sample of subjects were asked to evaluate the included apps for perceived sleep behavior changes.

Results The average MARS app quality score on a 5-point scale was 3.3. Between 30-50% of participants believed that sleep tracker apps are likely to increase awareness about sleep patterns and sleep hygiene, infuence sleep hygiene habits, and are likely to encourage help seeking for sleep hygiene when required.

Conclusion Apps available for sleep self-management and tracking may be valuable tools for self-management of sleep disorder and/or improving sleep quality, yet they require improvement in terms of quality and content, highlighting the need for further validity studies.

Sleep Tracker - Sleep Health - Smartphone Applications - Behavioural Change - Consumer Sleep Technology - Mobile Devices

Full Text

References

REFERENCES
1 Fietze I. Sleep applications to assess sleep quality. Sleep Med Clin. 2016 Dec;11(4):461-8. DOI: https://doi.org/10.1016/j.jsmc.2016.08.008
2 Grandner MA. Sleep, health, and society. Sleep Med Clin. 2017 Mar;12(1):1-22. DOI: https://doi.org/10.1016/j.jsmc.2016.10.012
3 Yoo SS, Hu PT, Gujar N, Jolesz FA, Walker MP. A deficit in the ability to form new human memories without sleep. Nat Neurosci. 2007 Feb;10:385-92. DOI: https://doi.org/10.1038/nn1851
4 Rasch B, Born J. About sleep’s role in memory. Physiol Rev. 2013 Apr;93(2):681-766. DOI: https://doi.org/10.1152/physrev.00032.2012
5 Lim J, Dinges DF. A meta-analysis of the impact of short-term sleep deprivation on cognitive variables. Psychol Bull. 2010;136(3):375-89. DOI: https://doi.org/10.1037/a0018883
6 Van Dongen HPA, Maislin G, Mullington JM, Dinges DF. The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep. 2003 Mar;26(2):117-26. DOI: https://doi.org/10.1093/sleep/26.2.117
7 Minkel JD, Banks S, Hataik OO, Moreta MC, Jones CW, McGlinchey EL, et al. Sleep deprivation and stressors: evidence from elevated negative affect in response to mild stressors when sleep deprived. Emotion. 2012 Oct;12(5):1015-20.
8 Mendelsohn AR, Larrick JW. Sleep facilitates clearance of metabolites from the brain: glymphatic function in aging and neurodegenerative diseases. Rejuvenation Res. 2013 Dec;16(6):518-23. DOI: https://doi. org/10.1089/rej.2013.1530
9 Xie L, Kang H, Xu Q, Chen MJ, Liao Y, Thiyagarajan M, et al. Sleep drives metabolite clearance from the adult brain. Science. 2013 Oct;342(6156):373-7. DOI: https://doi.org/10.1126/science.1241224
10 Kawakami N, Takatsuka N, Shimizu H. Sleep disturbance and onset of type 2 diabetes. Diabetes Care. 2004 Jan;27(1):282-3. DOI: https://doi. org/10.2337/diacare.27.1.282
11 Xie D, Li W, Wang Y, Gu H, Teo K, Liu L, et al. Sleep duration, snoring habits and risk of acute myocardial infarction in China population: results of the INTERHEART study. BMC Public Health. 2014 May;14:531. DOI: https://doi.org/10.1186/1471-2458-14-531
12 Choi JW, Song JS, Lee YJ, Won T Bin, Jeong DU. Increased mortality in relation to insomnia and obstructive sleep apnea in Korean patients studied with nocturnal polysomnography. J Clin Sleep Med. 2017 Jan;13(1):49-56. DOI: https://doi.org/10.5664/jcsm.6386
13 Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. Joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion. J Clin Sleep Med. 2015;11(8):931-52. DOI: https://doi.org/10.5664/jcsm.4950
14 Vgontzas AN, Liao D, Bixler EO, Chrousos GP, Vela-Bueno A. Insomnia with objective short sleep duration is associated with a high risk for hypertension. Sleep. 2009 Apr;32(4):491-7. DOI: https://doi. org/10.1093/sleep/32.4.491
15 Sun W, Huang Y, Wang Z, Yu Y, Lau A, Ali G, et al. Sleep duration associated with body mass index among Chinese adults. Sleep Med. 2015 May;16(5):612-6. DOI: https://doi.org/10.1016/j.sleep.2014.12.011
16 Kakizaki M, Kuriyama S, Sone T, Ohmori-Matsuda K, Hozawa A, Nakaya N, et al. Sleep duration and the risk of breast cancer: the Ohsaki cohort study. Br J Cancer. 2008 Sep;99:1502-5. DOI: https://doi.org/10.1038/sj.bjc.6604684
17 Jiao L, Duan Z, Sangi-Haghpeykar H, Hale L, White DL, El-Serag HB. Sleep duration and incidence of colorectal cancer in postmenopausal women. Br J Cancer. 2013 Jan;108:213-21. DOI: https://doi.org/10.1038/bjc.2012.561
18 Stickley A, Leinsalu M, DeVylder JE, Inoue Y, Koyanagi A. Sleep problems and depression among 237 023 community-dwelling adults in 46 low- and middle-income countries. Sci Rep. 2019 Aug;9:12011. DOI: https://doi.org/10.1038/s41598-019-48334-7
19 Neter E, Brainin E. eHealth literacy: extending the digital divide to the realm of health information. J Med Internet Res. 2012 Jan/Feb;14(1):e19. DOI: https://doi.org/10.2196/jmir.1619
20 World Health Organization (WHO). Global difusion of eHealth: making universal health coverage achievable. Report of the Third Global Survey on eHealth. Geneva: WHO; 2016.
21 IMS Institute for Healthcare Informatics. Patient adoption of mHealth. Use, evidence and remaining barriers to mainstream acceptance. Parsippany: IMS; 2015.
22 Choi YK, Demiris G, Lin SY, Iribarre n SJ, Landis CA, Thompson HJ, et al. Smartphone applications to support sleep self-management: review and evaluation. J Clin Sleep Med. 2018 Oct;14(10):1783-90. DOI: https://doi.org/10.5664/jcsm.7396
23 Ong AA, Gillespie MB. Overview of smartphone applications for sleep analysis. World J Otorhinolaryngol Neck Surg. 2016 Mar;2(1):45-9. DOI: https://doi.org/10.1016/j.wjorl.2016.02.001
24 Fino E, Mazzetti M. Monitoring healthy and disturbed sleep through smartphone applications: a review of experimental evidence. Sleep Breath. 2018 Apr;23:13-24. DOI: https://doi.org/10.1007/s11325-018-1661-3
25 Camacho M, Robertson M, Abdullatif J, Certal V, Kram YA, Ruoff CM, et al. Smartphone apps for snoring. J Laryngol Otol. 2015 Sep;129(10):974-9. DOI: https://doi.org/10.1017/S0022215115001978
26 Toon E, Davey MJ, Hollis SL, Nixon GM, Horne RSC, Biggs SN. Comparison of commercial wrist-based and smartphone accelerometers, actigraphy, and PSG in a clinical cohort of children and adolescents. J Clin Sleep Med. 2016 Mar;12(3):343-50. DOI: https://doi.org/10.5664/jcsm.5580
27 Bhat S, Ferraris A, Gupta D, Mozafarian M, DeBari VA, Gushway-Henry N, et al. Is there a clinical role for smartphone sleep apps? Comparison of sleep cycle detection by a smartphone application to polysomnography. J Clin Sleep Med. 2015 Jul;11(7):709-15. DOI: https://doi.org/10.5664/jcsm.4840
28 Natale V, Drejak M, Erbacci A, Tonetti L, Fabbri M, Martoni M. Monitoring sleep with a smartphone accelerometer. Sleep Biol Rhythms. 2012 Jul;10(4):287-92. DOI: https://doi.org/10.1111/j.1479-8425.2012.00575.x
29 Min JK, Doryab A, Wiese J, Amini S, Zimmerman J, Hong JI. Toss “n” turn. New York: Association for Computing Machinery; 2014. DOI: https://doi.org/10.1145/2556288.2557220
30 Kolla BP, Mansukhani S, Mansukhani MP. Consumer sleep tracking devices: a review of mechanisms, validity and utility. Expert Rev Med Devices. 2016 Apr;13(5):497-506. DOI: https://doi.org/10.1586/17434440.2016.1171708
31 Ko PRT, Kientz JA, Choe EK, Kay M, Landis CA, Watson NF. Consumer sleep technologies: a review of the landscape. J Clin Sleep Med. 2015 Dec;11(12):1455-61. DOI: https://doi.org/10.5664/jcsm.5288
32 Santo K, Richtering SS, Chalmers J, Thiagalingam A, Chow CK, Redfern J. Mobile phone apps to improve medication adherence: a systematic stepwise process to identify high-quality apps. JMIR mHealth uHealth. 2016 Oct/Dec;4(4):e132. DOI: https://doi.org/10.2196/mhealth.6742
33 Anderson K, Burford O, Emmerton L. App chronic disease checklist: protocol to evaluate mobile apps for chronic disease self-management. JMIR Res Protoc. 2016 Oct/Dec;5(4):e204. DOI: https://doi. org/10.2196/resprot.6194
34 Creber RM, Maurer MS, Reading M, Hiraldo G, Hickey KT, Iribarren S. Review and analysis of existing mobile phone apps to support heart failure symptom monitoring and self-care management using the Mobile Application Rating Scale (MARS). JMIR mHealth uHealth. 2016 Apr/ Jun;4(2):e74. DOI: https://doi.org/10.2196/mhealth.5882
35 Santoro E, Castelnuovo G, Zoppis I, Mauri G, Sicurello F. Social media and mobile applications in chronic disease prevention and management. Front Psychol. 2015;6:567. DOI: https://doi.org/10.3389/fpsyg.2015.00567
36 Singh K, Drouin K, Newmark LP, Rozenblum R, Lee J, Landman A, et al. Developing a framework for evaluating the patient engagement, quality, and safety of mobile health applications. Issue Brief (Commonw Fund). 2016 feb;5:1-11.
37 Scott H, Lack L, Lovato N. A pilot study of a novel smartphone application for the estimation of sleep onset. J Sleep Res. 2018 Jun;27(1):90-7. DOI: https://doi.org/10.1111/jsr.12575
38 Khosla S, Deak MC, Gault D, Goldstein CA, Hwang D, Kwon Y, et al. Consumer sleep technology: an American Academy of Sleep Medicine position statement. J Clin Sleep Med. 2018 May;14(5):877-80. DOI: https://doi.org/10.5664/jcsm.7128
39 Ho FYY, Chung KF, Yeung WF, Ng TH, Kwan KS, Young KP, et al. Self-help cognitive-behavioral therapy for insomnia: a meta-analysis of randomized controlled trials. Sleep Med Rev. 2015 Feb;19:17-28. DOI: https://doi.org/10.1016/j.smrv.2014.06.010
40 Chung KF, Lee CT, Yeung WF, Chan MS, Chung EWY, Lin WL. Sleep hygiene education as a treatment of insomnia: a systematic review and meta-analysis. Fam Pract. 2018 Aug;35(4):365-75. DOI: https://doi.org/10.1093/fampra/cmx122
41 Stepanski EJ, Wyatt JK. Use of sleep hygiene in the treatment of insomnia. Sleep Med Rev. 2003 Jun;7(3):215-25. DOI: https://doi.org/10.1053/smrv.2001.0246
42 Al-Kandari S, Alsalem A, Al-Mutairi S, Al-Lumai D, Dawoud A, Moussa M. Association between sleep hygiene awareness and practice with sleep quality among Kuwait University students. Sleep Heal. 2017 Oct;3(5):342-7. DOI: https://doi.org/10.1016/j.sleh.2017.06.004
43 Suen LKP, Tam WWS, Hon KL. Association of sleep hygiene-related factors and sleep quality among university students in Hong Kong. Hong Kong Med J. 2010 Jun;16(3):180-5.
44 Patel P, Kim JY, Brooks LJ. Accuracy of a smartphone application in estimating sleep in children. Sleep Breath. 2017;21:505-11. DOI: https:// doi.org/10.1007/s11325-016-1425-x