Remotely Delivered Interventions for Sleep

Insomnia affects up to half of the adults in their lifetime and is a difficult condition to treat. Pharmaceuticals can carry dangerous side effects and have limited effectiveness, and the gold-standard nonpharmaceutical treatment, Cognitive Behavioral Therapy (CBT), is difficult to access and has a delayed treatment effect of 4-6 weeks. Furthermore, both pharmaceuticals and CBT can be cost prohibitive for many people. There is a need for treatments that are more accessible, work rapidly, and have fewer side effects. Mind-body interventions are a promising option because they target psycho-emotional aspects of insomnia and produce physical relaxation needed for sleep. For example, prior research has shown interventions involving yoga, meditation, tai chi, music, and more to be associated with improved sleep outcomes including sleep latency, quality, and duration. Importantly, many mind-body practices have the capacity to be delivered remotely, via video conference, video/audio recording, cell phone app, or professional training with self-practice, making them increasingly accessible to populations that cannot or will not seek in-clinic treatment.

Research on remotely-delivered interventions for sleep is just beginning to emerge. There has been a success in delivering CBT for insomnia, remotely, via telemedicine, and cell phone apps, showing that individuals with insomnia may respond well to remote treatments, accessible when needed, without a trip to see a doctor, and without restrictive financial costs. Research on remotely-delivered mind-body interventions for sleep, is more limited, though promising, and deserves further exploration. Remote delivery of safe and accessible, inexpensive mind-body interventions, capable of facilitating sleep at any time of day or night, could be a very important step toward empowering individuals from all walks of life, to improve their sleep. Such practices could fit into the context of current insomnia care by being used instead of, or alongside gold-standard CBT; or they could be used in a stepped-care approach (while awaiting access to, or following treatment with CBT for non-responders). Understanding the effects of remotely-delivered mind-body practices for sleep could help to shape a comprehensive vision of care for individuals suffering from insomnia.

This article collection will feature studies evaluating the use of remotely-delivered mind-body interventions for improved sleep. Interventions should be practiced remotely (i.e. at home or elsewhere) and may be delivered via app, video conference, audio or video recording, telephone, self-practice, or other remote methods, and may include mind-body practices with a physical/movement element (such as yoga asana, pranayama, tai chi, or other); or practices that involve watching or listening to audio/visual media (such as music, visual imagery/video, or guided meditations and more). This collection welcomes any study on this topic, including clinical trials, protocols, focus groups, case studies and more. The mind-body practice should be defined, described, and justified, and the remote delivery method can be a novel app or website, or a commonly used platform such as YouTube, REDCap, or simply a recording distributed to participants. Primary outcomes should be related to sleep (e.g. sleep latency, duration, quality, nighttime waking, daytime sleepiness, etc.), and measured via self-report survey and/or remotely-collected measures, including portable biomonitors/sleep trackers, with limited in-clinic visits, for necessary intervention training and outcome measurements.