A Randomised Controlled Trial of a Digital, Small Incentive-based Intervention for Working Adults with Short Sleep


 
 
 We evaluated the efficacy of a digitally-delivered, small and scalable incentive-based intervention program on sleep and wellbeing in short-sleeping, working adults.
 
 
 
 A 22-week, parallel-group, randomised controlled trial was conducted on 21-40y participants gifted with Fitbit TM devices to measure sleep for 2+ years, as part of a broader healthy lifestyle study. 225 short sleepers (141 males; average time-in-bed, TIB<7h) were randomly assigned in a 2:1 ratio to Goal-Setting or Control groups. The Goal-Setting group received health vouchers (~USD 0.24) for meeting each sleep goal (i.e. increasing weeknight TIB by 30 mins / sleeping before midnight).The study spanned 3 Phases: 1) 2-week Baseline, 2) 10-week Intervention, and 3) 10-week Follow-Up. Wellbeing questionnaires were administered on Weeks 1-2, 11-12 and 21-22.
 
 
 
 Baseline weeknight TIB (mean±SD) was 387±43 min (Goal-Setting) and 399±44 min (Control), while bedtime was 00:53±01:13 (Goal-Setting), and 00:38±00:56 (Control). No difference in sleep outcomes were observed at study endpoints, but exploratory week-by-week analysis showed that on Weeks 3-5, TIB in the Goal-Setting group increased (9-18 min; ps<0.05) while on Week 5, bedtimes shifted earlier (15 min; p<0.01) compared to Baseline. Morning sleepiness was reduced in the Goal-Setting group (mean(SEM)=-3.17(1.53); p=0.04). Between-group differences were not significant (p=0.62). Main barriers to sleeping longer were work hours (35%), followed by leisure activities (23%) and family commitments (22%).
 
 
 
 Our program resulted in encouraging subjective sleep improvements and short-term sleep extension but sustained transformation of sleep will probably require structural measures to overcome significant obstacles to sleep.
