Efficacy of a smartphone-based virtual companion to treat insomniac complaints in the general population: sleep diary monitoring versus an internet autonomous intervention (Preprint)

BACKGROUND
Insomnia is the most prevalent sleep disorder worldwide and cognitive behavioural therapy is the front-line treatment. Digital health technologies have a role to play in screening and delivering interventions remotely and without the need for human intervention. The KANOPEE app, which provides a screening and behavioural intervention for insomnia symptoms through an interaction with a virtual agent, showed encouraging results in previous studies during and after the COVID-19 lockdown, but has not yet been evaluated in a controlled study.

OBJECTIVE
This study aims at comparing the benefits of KANOPEE, a smartphone application proposing repeated interactions with a virtual companion to screen and deliver personalized recommendations to deal with insomnia complaints; with another application proposing an electronic sleep diary and named “My Sleep Diary”. The acceptance and potential benefits of these digital solutions are demonstrated in real-life settings (i.e. without soliciting human medical resources) and in the general population.

METHODS
Subjects were included if they downloaded one of the apps between December 2020 and October 2021; and were of legal age. Both apps are available on downloading platforms in France and both groups were equivalent in terms of baseline characteristics. Primary outcome was Insomnia Severity Index (ISI) and secondary outcomes were Total Sleep Time (TST) and Sleep Efficiency (SE).

RESULTS
535 users completed the 17-day intervention with KANOPEE and 489 users completed My Sleep Diary for 17 days. A differential effect was obtained for KANOPEE users compared to My Sleep Diary users regarding ISI score (interaction Time*Group: F[2,2014] = 16.9, P<.001) and TST (KANOPEE users gained 48 minutes of sleep after intervention, while My Sleep Diary users gained only 16 minutes of sleep). Patients with the most severe ISI score (> 15) benefited the most from KANOPEE (interaction severity*Time: F[4,2014] = 26.3, P<.001).

CONCLUSIONS
KANOPEE provides significantly greater benefits than an electronic sleep diary regarding reduction of insomnia complaints in a self-selected sample of the general population.

CLINICALTRIAL
NCT05074901

Auteurs Bordeaux Neurocampus