The Dream On Study: A randomised controlled trial of efficacy and acceptability of a smart phone application in improving sleep in young people.

The Sleep Ninja app: The Sleep Ninja is a mobile phone application (app) designed for use on iOS (i.e. Apple) and Android (i.e. Samsung) smartphones and is downloaded via the App Store or Google Play. The app was derived from CBT-I, which is the gold standard, evidence-based treatment for insomnia. It includes the following skills and strategies: psychoeducation, sleep scheduling, stimulus control, sleep focused cognitive therapy, sleep hygiene and behavioural activation. The app takes the form of a chat-bot, i.e. when the app is open, users communicate with the Sleep Ninja in the app via a forced choice text messaging platform. The Sleep Ninja, who acts as a sleep coach is programmed to respond to the selection made by the user. That is, the app is interactive and responsive to user input. The app is based on gaming principles and users progress through six levels or “belts”, starting at a “white belt” and working their way up to “black belt” status. To “level up” and gain the next belt, users must complete one training session (which takes approximately 5 minutes) and at least three nights of sleep tracking within the app’s sleep diary portal, within a 7-day period. At the completion of each level, users are given feedback about their sleep. Users are also given specific advice if they indicate varying their wake-up time by more than two hours from the previous day or recording less than six hours total sleep time. There are additional optional app features that users can access at their choosing, which include a meditation recording, extra sleep information, sleep tips and a “Get Help Now” button that links directly to Australian crisis support services including Kids Helpline. If participants agree to it, the app sends reminder notifications to: enter sleep diaries, begin winding down for sleep, complete training sessions, and return after periods of inactivity. Depending on the frequency of use, participants can take as little as 18 days to progress to “black belt” status. Participants will have access to the app for 6-weeks. Adherence is assessed by recording the number of lessons completed, time taken to complete each lesson, and the number of times each section of the app is accessed.