Evaluating User Compliance in Mobile Health Apps: Insights from a 90-Day Study Using a Digital Sleep Diary

Abstract

Sleep diaries are the gold standard for subjective assessment of sleep variables in clinical practice. Digitization of sleep diaries is needed, as paper versions are prone to human error, memory bias, and difficulties monitoring compliance. Methods: 45 healthy eligible participants (Mage = 50.3 years, range 23–74, 56% female) were asked to use a sleep diary mobile app for 90 consecutive days. Univariate and bivariate analysis was used for group comparison and linear regression for analyzing reporting trends and compliance over time. Results: Overall compliance was high in the first two study months but tended to decrease over time (p < 0.001). Morning and evening diary entries were highly correlated (r = 0.932, p < 0.001) and participants significantly answered on average 4.1 days (95% CI [1.7, 6.6]) more often in the morning (M = 60.2, sd = 22.1) than evening ((M = 56.1, sd = 22.2), p < 0.001). Conclusion: Using a daily diary assessment in a longitudinal sleep study with a sleep diary delivered through a mobile application was feasible, and compliance in this study was satisfactory.