Efficacy of an m-health physical activity and sleep health intervention for adults: a randomized waitlist-controlled trial

Introduction: Interventions that improve both physical activity and sleep quality may be more effective in improving overall health. The purpose of the Synergy Study is to test the efficacy of a mobile health combined behavior intervention targeting physical activity and sleep quality. Study design: Randomized, waitlist-controlled trial. Setting/participants: This study had an app-based delivery mode, Australia-wide. The participants were 160 adults who reported insufficient physical activity and poor sleep quality in an eligibility survey. Intervention: The intervention was a mobile app providing educational resources, goal setting, self-monitoring, and feedback strategies. It included 12 weeks of personalized support including weekly reports, tool sheets, and prompts. Main Outcome Measures: Outcomes were assessed at baseline, 3 months (primary), and 6 months (secondary endpoint). Self-reported minutes of moderate-to-vigorous intensity physical activity and sleep quality were co-primary outcomes. Resistance training; sitting time; sleep hygiene; sleep timing variability; insomnia severity; daytime sleepiness; quality of life; and depression, anxiety, and stress symptoms were secondary outcomes. Data were collected between June 2017 and February 2018 and analyzed in August 2018. Results: At 3 months, between-group differences in moderate-to-vigorous intensity physical activity were not statistically significant (p=0.139). Significantly more participants in the intervention group engaged in ≥2 days/week (p=0.004) of resistance training. The intervention group reported better overall sleep quality (p=0.009), subjective sleep quality (p=0.017), sleep onset latency (p=0.013), waketime variability (p=0.018), sleep hygiene (p=0.027), insomnia severity (p=0.002), and lower stress symptoms (p=0.032) relative to waitlist controls. At 6 months, group differences were maintained for sleep hygiene (p=0.048), insomnia severity (p=0.002), and stress symptoms (p=0.006). Differences were observed for bedtime variability (p=0.023), sleepiness (p<0.001), daytime dysfunction (p=0.039), and anxiety symptoms (p=0.003) at 6 months, but not 3 months. Conclusions: This remotely delivered intervention did not produce statistically significant between-group differences in minutes of moderate-to-vigorous intensity physical activity. Significant short-term differences in resistance training and short- and medium-term differences in sleep health in favor of the intervention were observed. Trial Registration: This study is registered at anzctr.org.au ACTRN12617000376347.