0381 High levels of patient engagement with a novel sleep telehealth platform in the US military

Abstract

Abstract Introduction Despite very high prevalence and documented adverse consequences of insufficient and disturbed sleep in the US military, there are well-recognized barriers limiting access to evidence-based sleep interventions within the military health system (MHS). Chief among these is an insufficient number of trained sleep specialists and sleep centers. As part of a larger implementation effort, the purpose of this pilot study was to evaluate patient engagement with a novel sleep telehealth platform at a busy military treatment facility. Methods The sleep telehealth platform consists of an online web portal for patients and providers, a secure mobile app, and integrated wearable sensors using an off the shelf commercial solution (COTS; in this study, Fitbit). The purposes of this platform are to 1) help primary care managers (PCMs) assess sleep complaints, 2) empower patients and PCMs to make evidence-based sleep treatment decisions, 3) deliver evidence-based behavioral sleep treatments via mobile devices, and 4) connect patients with sleep specialists in virtual or physical sleep centers. Participants were recruited from the Internal Medicine clinic and the Sleep Disorders Center at Walter Reed National Military Medical Center (WRNMMC). Inclusion criteria included ages of 18-75 years and self or provider referral for sleep problems, including insufficient sleep duration. In addition to wearing the COTS sleep tracker, participants completed a baseline assessment and 2x/daily diaries for ten days, and a brief satisfaction survey. Results Participants included 35 patients (57% female, mean age=44.7 years). One hundred percent of participants wore the COTS sleep tracker and completed the post-monitoring assessment. Satisfaction survey results indicated that 96.7% of participants found completing the 10-day continuous sleep monitoring assessments to be “easy” or “very easy,” and 96.7% of those who completed the monitoring expressed a preference for app-based sleep treatment either alone or in conjunction with virtual or in person care. Finally, participants offered suggestions to optimize the app and platform for pending clinical implementation. Conclusion Results of this pilot study demonstrate high levels of patient engagement with the sleep telehealth platform. Given the large number of patients seeking treatment and the shortage of trained specialist providers, sleep telehealth is a promising pathway to increase access to evidence-based care. Support (If Any) This research was supported by an investigator-initiated research award from the Department of Defense (via the Medical Technology Enterprise Consortium) to the University of Maryland, Baltimore (PI: EMW).