Feasibility and acceptability of a digital intervention for insomnia in adults with attention deficit hyperactivity disorder

Abstract

Sleep problems were found to be particularly common in individuals with attention deficit hyperactivity disorder (ADHD). However, few studies have evaluated the efficacy and feasibility of psychological interventions for insomnia in such individuals. The present study evaluated the feasibility, acceptability, and preliminary efficacy of a digital application based on Cognitive Behavioural Therapy for insomnia for adults with ADHD. Six participants were randomized to use the application or to watch psychoeducational videos on sleep hygiene. Both groups were asked to fill out sleep diary measures for seven weeks and to complete a set of questionnaires regarding insomnia severity, ADHD symptoms, and other areas of functioning before and after the intervention. Semi-structured interviews were conducted to collect qualitative feedback from participants after the intervention. Given that the final sample size was not large enough for conducting meaningful statistical analysis, we were unable to conclude the efficacy of the intervention. However, we evaluated the feasibility of the intervention based on the eligibility rate and adherence level. We also assessed the acceptability of the intervention by evaluating participants’ responses in the unified theory of acceptance and use of technology (UTAUT) survey, as well as conducting directed qualitative content analysis of participants’ feedback. The results indicated limited feasibility and acceptability of the intervention. Factors contributing to such outcomes were identified, including treatment duration, conciseness, content, novelty, attractiveness, and elements of rewards. Suggestions for further modification of the application were made. More general implications regarding the development of digital applications for ADHD users were discussed.