ABSTRACT
Objectives/Introduction: 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. 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. Method(s): 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). Result(s): 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 x Group: F [2,2014] = 16.9, p < 0.001) and TST (KANOPEE users gained 48 min of sleep after intervention, while My Sleep Diary users gained only 16 min of sleep). Patients with the most severe ISI score (>15) benefited the most from KANOPEE (interaction severity x Time: F [4,2014] = 26.3, p < 0.001). Conclusion(s): KANOPEE provides significantly greater benefits than an electronic sleep diary regarding reduction of insomnia complaints in a self-selected sample of the general population.
ABSTRACT
The COVID-19 crisis has generated an increase of sleep problems in the general population. Digital technologies can help dealing with mental health repercussions of COVID-19 but their acceptance by the population need to be better understood. KANOPEE is a smartphone application providing interactions with a virtual companion to screen and deliver personalized advices to deal with sleep problems. In this study we tried to highlight the factors associated with acceptance of this app, among factors including user characteristics, perceived trustworthiness of the virtual companion and context of use. 3,479 users answered the acceptance questionnaires, with a very positive attitude towards the app. Results indicate that age, education, familiarity with technologies, trustworthiness of the virtual agent and length of interaction are significantly associated with acceptance of the app. To conclude, this study is one of the first to measure acceptance of a virtual companion providing support during the COVID-19 crisis, and provide avenues of research for design and evaluation of intelligent virtual agents for health. © 2021 ACM.