Enhancing Adherence to Cognitive Behavioral Therapy for Insomnia through Machine and Social Persuasion

Cognitive behavioral therapy for insomnia (CBT-I) is a treatment that focuses on psychological and behavioral factors. Although the CBT-I has proven efficacy, yet 32%-V89% of patients fail to consistently follow recommendations. The critical challenge of CBT-I is how to enhance the adherence of patients to therapy. In this study, we propose a persuasion method which integrates machine-generated persuasion and socially-generated persuasion for enhancing adherence, and we design a mobile application Win-Win ASleep (WWaS). We performed a 6-week study to evaluate the usability of WWaS on enhancing behavioral and recording adherence in comparison to a paper-based diary. Results show that machine-generated persuasion and socially-generated persuasion enhanced the adherence of patients in different manner, and WWaS assists users keeping a sleep diary accurate and complete. These higher quality records of sleep diary benefits the therapy. We also discuss strategies and provide recommendations for designing similar mobile applications to promote healthy behavior.