Using Consumer Sleep Trackers for Sleep Extension Interventions: Retention, Adherence, and User Experiences

Abstract Study Objectives Consumer sleep trackers (CSTs) can provide insights into sleep behaviors for behavioral interventions. This study aimed to describe the implementation, adherence, and participant perceptions of CSTs across two behavioral sleep extension studies: Study 1, the Sleep Technology Intervention to Target Cardiometabolic Health (STITCH) and Study 2, the Sleep Optimization for Type 1 Diabetes (Sleep-Opt). Methods Both studies employed randomized controlled trial designs. Participants were provided with CSTs and engaged in structured coaching sessions via Zoom or phone, supplemented with sleep education materials. Adherence was measured by the number of days with sleep data recorded during the intervention periods (8 weeks for Study 1, 12 weeks for Study 2). Participant feedback was collected through end-of-study surveys that included open-ended questions with free text answers to assess usability, satisfaction, and perceived impact of CSTs. Open-ended feedback was analyzed using Reflexive Thematic Analysis. Results Study 1 enrolled 60 participants, and Study 2 enrolled 73 participants. Adherence was 89% and 86% and retention was 100% and 86%, respectively. Open-ended feedback revealed three themes: positive aspects of device use, negative aspects of device use, and device usability and data interactions. Participants the CST helpful for motivation and goal tracking. However, technical issues, discomfort, and emotional responses to sleep data were noted as barriers. Conclusions CSTs, when paired with personalized coaching and support, can effectively be used to promote participant engagement in sleep behavior change studies. Continued research is essential to refine wearable technology interventions to maximize their impact on health behavior modification. This paper is part of the Consumer Sleep Technology Collection