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.
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