ABSTRACT
Introduction: Students pursuing postsecondary education are a population at significant risk for both sleep problems and poor mental health outcomes such as depression and anxiety. Interventions such as sleep hygiene education and cognitive behavioural therapy (CBT) are commonly used treatments for sleep problems and have been effective in improving sleep and mental health in the university student population. Digitally-delivered CBT has also been shown to be effective in improving sleep in youth, however it has not been evaluated in the postsecondary student population. Materials and Methods: We conducted a systematic review of the quantitative and qualitative evidence on the effectiveness and user experiences of digital sleep interventions to improve sleep and mental health outcomes in postsecondary students. We searched MEDLINE, CINAHL, Embase, and APA PsycInfo for studies published from 2000 to 2021. We included randomized controlled trials (RCTs), cohort studies, case-control studies, qualitative studies, and mixed methods studies. Pairs of reviewers independently screened and critically appraised studies, and extracted data. We aimed to use a sequential approach at the review level to synthesize and integrate data across qualitative and quantitative research studies. Results: We screened 5361 citations and 58 full text articles. Eight relevant RCTs and one cohort study were critically appraised. Three interventions were assessed including CBT, digital sleep hygiene education, and relaxation music. Most studies were assessed as high risk of bias. Given the methodological limitations of the included studies, we are unable to conclude on the effectiveness of digital sleep interventions for postsecondary students. We did not identify any qualitative studies. Conclusions: Methodological limitations preclude firm conclusions. Further research is needed to assess the effectiveness of digital alternatives for delivering sleep interventions to improve sleep and mental health outcomes in postsecondary students. Qualitative studies exploring the views and preferences of students and providers are required to inform the development of novel interventions that are acceptable in this population. Acknowledgements: Canadian Institutes of Health Science (CIHR) Operating Grant: Knowledge Synthesis: COVID-19 in Mental Health & Substance Use