Using actigraphy feedback to improve sleep in soldiers: an exploratory trial

Abstract

Objectives: The objective of this study was to assess the impact of wearing an actigraph and receiving personalized feedback on the sleep of a high-risk occupational group: United States soldiers recently returned from a combat deployment.

Design: Following a baseline survey with a full sample, a subsample of soldiers wore an actigraph, received feedback, and completed a brief survey. Two months later, the full sample completed a follow-up survey. The actigraph intervention involved wearing an actigraph for 3 weeks and then receiving a personalized report about sleep patterns and an algorithm-based estimate of cognitive functioning derived from individual sleep patterns.

Results: Propensity score matching with a genetic search algorithm revealed that subjects in the actigraph condition (n=43) reported fewer sleep problems (t value = -2.55, P<.01) and getting more sleep hours (t value =1.97, P<.05) at follow-up than those in a matched comparison condition (n=43, weighted). There were no significant differences in functioning, somatic symptoms, and mental health outcomes (posttraumatic stress disorder symptoms and depression). A significant interaction indicated that the actigraph had a more beneficial effect on those with more somatic symptoms at baseline but not those with more sleep problems. Most participants rated the personalized report as helpful.

Conclusion: Actigraphs combined with personalized reports may offer a useful, simple intervention to improve the sleep patterns of large, high-risk occupational groups.

Keywords: Actigraph; High-risk occupation; Military; Nudges; Soldiers.