

It is the most prevalent adolescent sleep disorder, with community surveys identifying up to one-third of adolescents with significant symptoms of insomnia. It includes difficulties initiating, maintaining, or returning to sleep, with the sleep disturbance occurring at least three nights per week for 3 months and causing impairment in daytime functioning.

Insomnia is a chronic dissatisfaction with sleep quantity or quality, despite an adequate opportunity to sleep. Statistically significant pre-post improvements were found in weekly diaries of sleep efficiency ( P=.005) and sleep quality ( P=.001) and on measures of sleep (SCI: P=.001 and Insomnia Severity Index: P=.001), low mood (MFQ: P=.03), and anxiety (RCADS: P=.005). Satisfaction was high, with 84% (16/19) of the participants finding Sleepio helpful, 95% (18/19) indicating that they would recommend it to a friend, and 37% (7/19) expressing a definite preference for a digital intervention. Sleepio was acceptable, with 77% (30/39) of the participants activating their account and 54% (21/39) completing the program. The majority of participants (38/49, 78%) were not having any treatment for their insomnia, with the remaining 25% (12/49) receiving medication. Of the 39 participants, 36 (92%) scored 27 or greater on the MFQ for major depression and 20 (51%) had clinically elevated symptoms of anxiety. All participants scored less than 17 on the SCI, with 92% (36/39) participants scoring 15 or greater on the Insomnia Severity Scale, suggesting clinical insomnia.

Average baseline sleep efficiency was very poor (53%), with participants spending an average of 9.6 hours in bed but only 5.1 hours asleep.
