Assessment of Usability and Preliminary Effectiveness of a Digital Sleep Aid in an Italian Sample

NCT ID: NCT06926348

Last Updated: 2025-04-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-10

Study Completion Date

2026-03-10

Brief Summary

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Chronic insomnia affects approximately 30% of the Italian population, leading to significant impairments in daily functioning and overall health. While Cognitive Behavioral Therapy for Insomnia (CBT-I) is the recommended first-line treatment, access is limited due to a shortage of trained specialists and resources within the Italian healthcare system. This study aims to evaluate the usability, acceptability, and preliminary effectiveness of a mobile application designed to assist individuals with chronic insomnia. The app offers digital sleep diaries, personalized sleep hygiene education, relaxation exercises, and an interactive chatbot to promote healthy sleep behaviors. Fifty adult participants diagnosed with chronic insomnia will be randomly assigned to either the intervention group, which will use the mobile application alongside their usual treatment, or to a control group receiving only standard care. The primary outcomes will assess the app's usability and participants' adherence to sleep hygiene practices. Secondary outcomes will evaluate changes in insomnia severity, mood, and quality of life. Assessments will occur at the start of the study, after the 8-week intervention, and at a 6-month follow-up to explore the intervention's long-term effects.

Detailed Description

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This randomized controlled pilot trial evaluates a Digital Health Technology (DHT) developed as a Health \& Wellness tool aimed at supporting individuals diagnosed with chronic insomnia. Chronic insomnia significantly impacts quality of life and poses a considerable burden on healthcare systems. Despite Cognitive Behavioral Therapy for Insomnia (CBT-I) being the recommended first-line treatment, its limited accessibility in Italy necessitates scalable and innovative solutions. The DHT under investigation is a mobile application developed collaboratively by the University of Verona and private-sector partners, designed specifically for educational purposes and the promotion of healthy sleep behaviors.

The intervention is structured over an 8-week period, during which participants are expected to engage daily with the application. The DHT includes several core functionalities:

Digital Sleep Diaries: Participants document their sleep habits daily, including sleep onset latency, total sleep duration, wake after sleep onset, and sleep efficiency. This self-monitoring aims to increase sleep-awareness and encourage consistent engagement with healthy sleep behaviors.

Personalized Educational Content: Users gain access to educational modules designed according to CBT-I principles. Topics include optimizing the sleep environment, maintaining consistent sleep schedules, managing lifestyle factors affecting sleep, and addressing common misconceptions about sleep.

Relaxation and Mindfulness Exercises: The app provides guided audio and video exercises focusing on relaxation techniques such as deep breathing and progressive muscle relaxation, alongside mindfulness practices intended to reduce pre-sleep arousal and facilitate better sleep.

Interactive Chatbot: An integrated conversational agent assists users in navigating app functionalities, provides personalized reminders, motivational feedback, and real-time assistance, enhancing user engagement and compliance.

Participants (N=50) are recruited from the outpatient clinic at Borgo Roma Hospital, Verona. Eligible individuals are randomly assigned in a 1:1 ratio to either receive the DHT intervention combined with Treatment as Usual (DHT + TAU), or Treatment as Usual (TAU) alone. TAU involves standardized educational materials on sleep hygiene practices provided via printed booklets and continued management under the patient's usual healthcare provider.

Assessments are conducted at baseline (T0), immediately post-intervention (T1), and at a 6-month follow-up (T2). Primary outcomes focus on usability and acceptability, measured by the User Experience Questionnaire (UEQ), digital engagement metrics, and adherence to sleep hygiene practices via the Sleep Hygiene Index (SHI). Secondary outcomes assess preliminary efficacy regarding insomnia severity (Insomnia Severity Index - ISI), mood disturbances (Hospital Anxiety and Depression Scale - HADS), and overall health-related quality of life (Short Form Health Survey - SF-12).

Data collection employs the secure LimeSurvey platform to ensure participant confidentiality and data protection according to GDPR standards. Data analysis includes Linear Mixed Effects Models, exploratory analyses for identifying predictors of treatment response, and sensitivity analyses for assessing robustness of findings.

This feasibility trial aims to inform future large-scale studies by evaluating the potential benefits and limitations of using a scalable, non-medical DHT in the routine management of chronic insomnia. Results are anticipated to contribute substantially to the evidence base supporting digital interventions as viable adjuncts to standard care for insomnia.

Conditions

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Insomnia Chronic Insomnia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Digital Health Technology (DHT) + Treatment As Usual (TAU)

Participants in this arm receive an 8-week intervention involving a mobile app designed for chronic insomnia management. The app includes digital sleep diaries, personalized sleep hygiene education, cognitive strategies, relaxation and mindfulness exercises, and an interactive chatbot for enhanced engagement. This intervention complements standard treatment (TAU), which may include pharmacotherapy and routine clinical care.

Group Type EXPERIMENTAL

Digital Health Technology for Chronic Insomnia

Intervention Type BEHAVIORAL

A mobile application designed to support chronic insomnia management through digital self-monitoring of sleep patterns, personalized sleep hygiene education, cognitive strategies, relaxation and mindfulness exercises, and chatbot interactions. Users receive tailored notifications and educational content to encourage healthy sleep behaviors over an 8-week period. Existing pharmacological treatments prescribed prior to study enrollment continue unchanged

Treatment As Usual (TAU)

Participants assigned to this arm continue their usual insomnia management, including pharmacological treatments if prescribed, and receive standardized educational material on sleep hygiene practices via a printed booklet. They also maintain printed sleep diaries for self-monitoring throughout the 8-week study period.

Group Type ACTIVE_COMPARATOR

Treatment as Usual (TAU)

Intervention Type BEHAVIORAL

Participants receive standard sleep hygiene recommendations via a printed educational booklet. They maintain printed sleep diaries for daily self-monitoring throughout the 8-week intervention. Existing pharmacological treatments prescribed prior to study enrollment continue unchanged.

Interventions

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Digital Health Technology for Chronic Insomnia

A mobile application designed to support chronic insomnia management through digital self-monitoring of sleep patterns, personalized sleep hygiene education, cognitive strategies, relaxation and mindfulness exercises, and chatbot interactions. Users receive tailored notifications and educational content to encourage healthy sleep behaviors over an 8-week period. Existing pharmacological treatments prescribed prior to study enrollment continue unchanged

Intervention Type BEHAVIORAL

Treatment as Usual (TAU)

Participants receive standard sleep hygiene recommendations via a printed educational booklet. They maintain printed sleep diaries for daily self-monitoring throughout the 8-week intervention. Existing pharmacological treatments prescribed prior to study enrollment continue unchanged.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Adults aged 18 to 70 years
* Diagnosis of chronic insomnia according to DSM-5 criteria
* Willingness to participate in the study and provide informed consent
* Personal active email address
* Ownership of a compatible mobile device with internet access (for the DHT group)

Exclusion Criteria

* Medical conditions requiring hospital admission during the study period
* Comorbid diagnosis of sleep-related breathing disorders
* Neurological disorders affecting sleep (e.g., narcolepsy, parasomnias, epilepsy, neurodegenerative diseases)
* Currently receiving psychological treatment for insomnia or planning to do so within the next 6 months
* Incompatible smartphone or lack of internet access (for DHT group)
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Santer Reply S.p.A. Milan, Italy

UNKNOWN

Sponsor Role collaborator

daVi Digital Medicine s.r.l. Verona, Italy

UNKNOWN

Sponsor Role collaborator

QStep s.r.l. Verona, Italy

UNKNOWN

Sponsor Role collaborator

Fondazione RIDE2Med, Milan, Italy

UNKNOWN

Sponsor Role collaborator

Universita di Verona

OTHER

Sponsor Role lead

Responsible Party

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Elena Antelmi

Associate Professor of Neurology and Clinical Neurologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Ospedale Borgo Roma - Neurologia B

Verona, Verona, Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Elena Antelmi, Professor - Neurology

Role: CONTACT

+393293526335

Giacomo Carollo, MSc - Psychology

Role: CONTACT

+393454361133

Facility Contacts

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Elena Antelmi, Professor - Neurology

Role: primary

3293526335

Giacomo Carollo, MSc - Psychology

Role: backup

+393454361133

References

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Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361-70. doi: 10.1111/j.1600-0447.1983.tb09716.x.

Reference Type BACKGROUND
PMID: 6880820 (View on PubMed)

Watanabe Y, Kuroki T, Ichikawa D, Ozone M, Uchimura N, Ueno T. Effect of smartphone-based cognitive behavioral therapy app on insomnia: a randomized, double-blind study. Sleep. 2023 Mar 9;46(3):zsac270. doi: 10.1093/sleep/zsac270.

Reference Type BACKGROUND
PMID: 36355920 (View on PubMed)

Terzano MG, Parrino L, Cirignotta F, Ferini-Strambi L, Gigli G, Rudelli G, Sommacal S; Studio Morfeo Committee. Studio Morfeo: insomnia in primary care, a survey conducted on the Italian population. Sleep Med. 2004 Jan;5(1):67-75. doi: 10.1016/j.sleep.2003.09.006.

Reference Type BACKGROUND
PMID: 14725829 (View on PubMed)

Stepanski EJ, Wyatt JK. Use of sleep hygiene in the treatment of insomnia. Sleep Med Rev. 2003 Jun;7(3):215-25. doi: 10.1053/smrv.2001.0246.

Reference Type BACKGROUND
PMID: 12927121 (View on PubMed)

Spielman AJ, Caruso LS, Glovinsky PB. A behavioral perspective on insomnia treatment. Psychiatr Clin North Am. 1987 Dec;10(4):541-53.

Reference Type BACKGROUND
PMID: 3332317 (View on PubMed)

Shapiro SL, Carlson LE, Astin JA, Freedman B. Mechanisms of mindfulness. J Clin Psychol. 2006 Mar;62(3):373-86. doi: 10.1002/jclp.20237.

Reference Type BACKGROUND
PMID: 16385481 (View on PubMed)

Shamim SA, Warriach ZI, Tariq MA, Rana KF, Malik BH. Insomnia: Risk Factor for Neurodegenerative Diseases. Cureus. 2019 Oct 26;11(10):e6004. doi: 10.7759/cureus.6004.

Reference Type BACKGROUND
PMID: 31807391 (View on PubMed)

Schuffelen J, Maurer LF, Lorenz N, Rotger A, Pietrowsky R, Gieselmann A. The clinical effects of digital cognitive behavioral therapy for insomnia in a heterogenous study sample: results from a randomized controlled trial. Sleep. 2023 Nov 8;46(11):zsad184. doi: 10.1093/sleep/zsad184.

Reference Type BACKGROUND
PMID: 37428712 (View on PubMed)

Riemann D, Espie CA, Altena E, Arnardottir ES, Baglioni C, Bassetti CLA, Bastien C, Berzina N, Bjorvatn B, Dikeos D, Dolenc Groselj L, Ellis JG, Garcia-Borreguero D, Geoffroy PA, Gjerstad M, Goncalves M, Hertenstein E, Hoedlmoser K, Hion T, Holzinger B, Janku K, Jansson-Frojmark M, Jarnefelt H, Jernelov S, Jennum PJ, Khachatryan S, Krone L, Kyle SD, Lancee J, Leger D, Lupusor A, Marques DR, Nissen C, Palagini L, Paunio T, Perogamvros L, Pevernagie D, Schabus M, Shochat T, Szentkiralyi A, Van Someren E, van Straten A, Wichniak A, Verbraecken J, Spiegelhalder K. The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023. J Sleep Res. 2023 Dec;32(6):e14035. doi: 10.1111/jsr.14035.

Reference Type BACKGROUND
PMID: 38016484 (View on PubMed)

Riemann D, Spiegelhalder K, Feige B, Voderholzer U, Berger M, Perlis M, Nissen C. The hyperarousal model of insomnia: a review of the concept and its evidence. Sleep Med Rev. 2010 Feb;14(1):19-31. doi: 10.1016/j.smrv.2009.04.002. Epub 2009 May 28.

Reference Type BACKGROUND
PMID: 19481481 (View on PubMed)

Riemann D, Nissen C, Palagini L, Otte A, Perlis ML, Spiegelhalder K. The neurobiology, investigation, and treatment of chronic insomnia. Lancet Neurol. 2015 May;14(5):547-58. doi: 10.1016/S1474-4422(15)00021-6. Epub 2015 Apr 12.

Reference Type BACKGROUND
PMID: 25895933 (View on PubMed)

Riemann D, Baglioni C, Bassetti C, Bjorvatn B, Dolenc Groselj L, Ellis JG, Espie CA, Garcia-Borreguero D, Gjerstad M, Goncalves M, Hertenstein E, Jansson-Frojmark M, Jennum PJ, Leger D, Nissen C, Parrino L, Paunio T, Pevernagie D, Verbraecken J, Weess HG, Wichniak A, Zavalko I, Arnardottir ES, Deleanu OC, Strazisar B, Zoetmulder M, Spiegelhalder K. European guideline for the diagnosis and treatment of insomnia. J Sleep Res. 2017 Dec;26(6):675-700. doi: 10.1111/jsr.12594. Epub 2017 Sep 5.

Reference Type BACKGROUND
PMID: 28875581 (View on PubMed)

Palagini L, Piarulli A, Menicucci D, Cheli E, Lai E, Bergamasco M, Mauri M, Kyle SD, Espie CA, Gemignani A. Metacognitive beliefs relate specifically to sleep quality in primary insomnia: a pilot study. Sleep Med. 2014 Aug;15(8):918-22. doi: 10.1016/j.sleep.2014.03.017. Epub 2014 May 9.

Reference Type BACKGROUND
PMID: 24916095 (View on PubMed)

Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev. 2002 Apr;6(2):97-111. doi: 10.1053/smrv.2002.0186.

Reference Type BACKGROUND
PMID: 12531146 (View on PubMed)

Ning Y, Teixayavong S, Shang Y, Savulescu J, Nagaraj V, Miao D, Mertens M, Ting DSW, Ong JCL, Liu M, Cao J, Dunn M, Vaughan R, Ong MEH, Sung JJ, Topol EJ, Liu N. Generative artificial intelligence and ethical considerations in health care: a scoping review and ethics checklist. Lancet Digit Health. 2024 Nov;6(11):e848-e856. doi: 10.1016/S2589-7500(24)00143-2. Epub 2024 Sep 17.

Reference Type BACKGROUND
PMID: 39294061 (View on PubMed)

Muench A, Vargas I, Grandner MA, Ellis JG, Posner D, Bastien CH, Drummond SP, Perlis ML. We know CBT-I works, now what? Fac Rev. 2022 Feb 1;11:4. doi: 10.12703/r/11-4. eCollection 2022.

Reference Type BACKGROUND
PMID: 35156100 (View on PubMed)

Morin CM, LeBlanc M, Daley M, Gregoire JP, Merette C. Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors. Sleep Med. 2006 Mar;7(2):123-30. doi: 10.1016/j.sleep.2005.08.008. Epub 2006 Feb 3.

Reference Type BACKGROUND
PMID: 16459140 (View on PubMed)

Mayer G, Jennum P, Riemann D, Dauvilliers Y. Insomnia in central neurologic diseases--occurrence and management. Sleep Med Rev. 2011 Dec;15(6):369-78. doi: 10.1016/j.smrv.2011.01.005. Epub 2011 Apr 9.

Reference Type BACKGROUND
PMID: 21481621 (View on PubMed)

Maurer LF, Espie CA, Kyle SD. How does sleep restriction therapy for insomnia work? A systematic review of mechanistic evidence and the introduction of the Triple-R model. Sleep Med Rev. 2018 Dec;42:127-138. doi: 10.1016/j.smrv.2018.07.005. Epub 2018 Sep 1.

Reference Type BACKGROUND
PMID: 30177248 (View on PubMed)

Mastin DF, Bryson J, Corwyn R. Assessment of sleep hygiene using the Sleep Hygiene Index. J Behav Med. 2006 Jun;29(3):223-7. doi: 10.1007/s10865-006-9047-6. Epub 2006 Mar 24.

Reference Type BACKGROUND
PMID: 16557353 (View on PubMed)

Lorenz N, Heim E, Roetger A, Birrer E, Maercker A. Randomized Controlled Trial to Test the Efficacy of an Unguided Online Intervention with Automated Feedback for the Treatment of Insomnia. Behav Cogn Psychother. 2019 May;47(3):287-302. doi: 10.1017/S1352465818000486. Epub 2018 Sep 6.

Reference Type BACKGROUND
PMID: 30185239 (View on PubMed)

Hong JS, Wasden C, Han DH. Introduction of digital therapeutics. Comput Methods Programs Biomed. 2021 Sep;209:106319. doi: 10.1016/j.cmpb.2021.106319. Epub 2021 Jul 29.

Reference Type BACKGROUND
PMID: 34364181 (View on PubMed)

Hofmann SG, Asnaani A, Vonk IJ, Sawyer AT, Fang A. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognit Ther Res. 2012 Oct 1;36(5):427-440. doi: 10.1007/s10608-012-9476-1. Epub 2012 Jul 31.

Reference Type BACKGROUND
PMID: 23459093 (View on PubMed)

Espie CA, Kyle SD, Hames P, Gardani M, Fleming L, Cape J. The Sleep Condition Indicator: a clinical screening tool to evaluate insomnia disorder. BMJ Open. 2014 Mar 18;4(3):e004183. doi: 10.1136/bmjopen-2013-004183.

Reference Type BACKGROUND
PMID: 24643168 (View on PubMed)

Espie CA, Henry AL. Disseminating cognitive behavioural therapy (CBT) for insomnia at scale: capitalising on the potential of digital CBT to deliver clinical guideline care. J Sleep Res. 2023 Dec;32(6):e14025. doi: 10.1111/jsr.14025. Epub 2023 Aug 29.

Reference Type BACKGROUND
PMID: 37642008 (View on PubMed)

Erten Uyumaz B, Feijs L, Hu J. A Review of Digital Cognitive Behavioral Therapy for Insomnia (CBT-I Apps): Are They Designed for Engagement? Int J Environ Res Public Health. 2021 Mar 12;18(6):2929. doi: 10.3390/ijerph18062929.

Reference Type BACKGROUND
PMID: 33809308 (View on PubMed)

Darden M, Espie CA, Carl JR, Henry AL, Kanady JC, Krystal AD, Miller CB. Cost-effectiveness of digital cognitive behavioral therapy (Sleepio) for insomnia: a Markov simulation model in the United States. Sleep. 2021 Apr 9;44(4):zsaa223. doi: 10.1093/sleep/zsaa223.

Reference Type BACKGROUND
PMID: 33151330 (View on PubMed)

Baek K, Jeong J, Kim HW, Shin DH, Kim J, Lee GH, Cho JW. Seasonal and Weekly Patterns of Korean Adolescents' Web Search Activity on Insomnia: Retrospective Study. JMIR Form Res. 2024 Oct 11;8:e52977. doi: 10.2196/52977.

Reference Type BACKGROUND
PMID: 39311496 (View on PubMed)

Castronovo V, Galbiati A, Sforza M, Poletti M, Giarolli L, Kuo T, Zucconi M, Manconi M, Hensley M, Morin C, Ferini-Strambi L. Long-term clinical effect of group cognitive behavioral therapy for insomnia: a case series study. Sleep Med. 2018 Jul;47:54-59. doi: 10.1016/j.sleep.2018.03.017. Epub 2018 Apr 11.

Reference Type BACKGROUND
PMID: 29753926 (View on PubMed)

Baglioni C, Altena E, Bjorvatn B, Blom K, Bothelius K, Devoto A, Espie CA, Frase L, Gavriloff D, Tuuliki H, Hoflehner A, Hogl B, Holzinger B, Jarnefelt H, Jernelov S, Johann AF, Lombardo C, Nissen C, Palagini L, Peeters G, Perlis ML, Posner D, Schlarb A, Spiegelhalder K, Wichniak A, Riemann D. The European Academy for Cognitive Behavioural Therapy for Insomnia: An initiative of the European Insomnia Network to promote implementation and dissemination of treatment. J Sleep Res. 2020 Apr;29(2):e12967. doi: 10.1111/jsr.12967. Epub 2019 Dec 19.

Reference Type BACKGROUND
PMID: 31856367 (View on PubMed)

American Psychiatric Association (2013). Manuale diagnostico e statistico dei disturbi mentali - Quinta edizione. DSM-5. Tr.it. Raffaello Cortina, Milano, 2015.

Reference Type BACKGROUND

Other Identifiers

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413CET

Identifier Type: -

Identifier Source: org_study_id

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