A clinical trial to evaluate the dayzz smartphone app on employee sleep, health, and productivity at a large US employer

Effects of Non-Pharmacological Sleep Interventions in Older Adults: A Systematic Review and Meta-Analysis

This study investigated the effects of non-pharmacological interventions on sleep in older people through a systematic review and meta-analysis. We conducted a literature search using eight electronic databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Participant characteristics, the contents of the evaluated interventions, and the measured outcomes were systematically reviewed for 15 selected studies. We performed a meta-analysis to estimate the effect size for overall, aggregated sleep outcomes. Due to the small number of studies available for each intervention, only the overall effectiveness of non-pharmacological sleep interventions was evaluated. The evaluated interventions included exercise, aromatherapy, acupressure, cognitive behavior therapy, and meditation. Our results demonstrated that non-pharmacological interventions showed statistically significant effects on sleep (effect size = 1.00, 95% confidence interval: 0.16, 1.85, I2 = 92%, p < 0.001). After confirming publication bias and removing outliers, we found no heterogeneity (I2 = 17%, p = 0.298), with a decrease in effect size to 0.70 (95% confidence interval: 0.47, 0.93). Non-pharmacological interventions are effective for improving sleep in older adults. Future studies should continue to investigate sleep problems and interventions addressing these problems in this demographic, particularly in older women. Objective measures should be used to follow-up on the evaluated sleep interventions over the long term.

Evaluating the impact of a sleep health education and a personalised smartphone application on sleep, productivity and healthcare utilisation among employees: results of a randomised clinical trial

OBJECTIVES

We evaluated an online Sleep Health and Wellness (SHAW) programme paired with dayzz, a personalised sleep training programme deployed via smartphone application (dayzz app) that promotes healthy sleep and treatment for sleep disorders, among employees at a large healthcare organisation.

DESIGN

Open-label, randomised, parallel-group controlled trial.

SETTING

A healthcare employer in the USA.

PARTICIPANTS

1355 daytime workers.

INTERVENTION

Participants were randomised to intervention (n=794) or control (n=561) on consent. Intervention participants received the SHAW educational programme at baseline plus access to the personalised dayzz app for up to 9 months. The control condition received the intervention at month 10.

PRIMARY AND SECONDARY OUTCOME MEASURES

Our primary outcome measures were sleep-related behavioural changes (eg, consistent sleep schedule); sleep behaviour tracked on an electronic sleep diary and sleep quality. Our secondary outcome measures included employee absenteeism, performance and productivity; stress, mood, alertness and energy; and adverse health and safety outcomes (eg, accidents).

RESULTS

At follow-up, employees in the intervention condition were more likely to report increased sleep duration on work (7.20 vs 6.99, p=0.01) and on free (8.26 vs 8.04, p=0.03) nights. At follow-up, the prevalence of poor sleep quality was lower in the intervention (n=160 of 321, 50%) compared with control (n=184 of 327, 56%) (p=0.04). The mean total dollars lost per person per month due to reduced workplace performance (presenteeism) was less in the intervention condition (US$1090 vs US$1321, p=0.001). Employees in the intervention reported fewer mental health visits (RR 0.72, 95% CI 0.56 to 0.94, p=0.01) and lower healthcare utilisation over the study interval (RR 0.81, 95% CI 0.67 to 0.98, p=0.03). We did not observe differences in stress (4.7 (95% CI 4.6 to 4.8) vs 4.7 (95% CI 4.6 to 4.8)), mood (4.5 (95% CI 4.4 to 4.6) vs 4.6 (95% CI 4.5 to 4.7)), alertness (4.9 (95% CI 4.8 to 5.0) vs 5.0 (95% CI 4.9 to 5.1)) or adverse health and safety outcomes (motor vehicle crashes: OR 0.82 (95% CI 0.34 to 1.9); near-miss crashes: OR=0.89 (95% CI 0.5 to 1.5) and injuries: 0.9 (95% CI 0.6 to 1.3)); energy was higher at follow-up in the intervention group (4.3 vs 4.5; p=0.03).

CONCLUSIONS

Results from this trial demonstrate that a SHAW programme followed by access to the digital dayzz app can be beneficial to both the employee and employer.

TRIAL REGISTRATION NUMBER

NCT04224285.