The mean age of onset of insomnia is 11 years, with symptoms being associated with significant mental health problems and tending to be persistent. It is the most prevalent adolescent sleep disorder, with community surveys identifying up to one-third of adolescents with significant symptoms of insomnia. It includes difficulties initiating, maintaining, or returning to sleep, with the sleep disturbance occurring at least three nights per week for 3 months and causing impairment in daytime functioning. Insomnia is a chronic dissatisfaction with sleep quantity or quality, despite an adequate opportunity to sleep. Statistically significant pre-post improvements were found in weekly diaries of sleep efficiency ( P=.005) and sleep quality ( P=.001) and on measures of sleep (SCI: P=.001 and Insomnia Severity Index: P=.001), low mood (MFQ: P=.03), and anxiety (RCADS: P=.005). Satisfaction was high, with 84% (16/19) of the participants finding Sleepio helpful, 95% (18/19) indicating that they would recommend it to a friend, and 37% (7/19) expressing a definite preference for a digital intervention. Sleepio was acceptable, with 77% (30/39) of the participants activating their account and 54% (21/39) completing the program. The majority of participants (38/49, 78%) were not having any treatment for their insomnia, with the remaining 25% (12/49) receiving medication. Of the 39 participants, 36 (92%) scored 27 or greater on the MFQ for major depression and 20 (51%) had clinically elevated symptoms of anxiety. All participants scored less than 17 on the SCI, with 92% (36/39) participants scoring 15 or greater on the Insomnia Severity Scale, suggesting clinical insomnia. Average baseline sleep efficiency was very poor (53%), with participants spending an average of 9.6 hours in bed but only 5.1 hours asleep.
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