Feasibility of a breath robot intervention to reduce sleep problems in posttraumatic stress disorder: A randomized controlled study

Abstract

Background: Patients with Posttraumatic stress disorder (PTSD) suffer from sleep problems. Robot interventions offer a novel approach to reducing these problems. However, it is unclear whether patients with PTSD accept and regularly use a robot intervention and whether it is effective. Objective: This randomized controlled study evaluated the feasibility of a novel breath robot intervention in PTSD patients. Methods: Thirty-one adults with PTSD according to DSM-V (PSSI-5) with impaired sleep (PSQI > 5) were randomly assigned to a 4-week robot intervention (Somnox 2) with human breath simulation or to a 4-week robot intervention without human breath simulation. The primary feasibility outcome was the proportion of randomized participants providing outcome data at post-treatment. Secondary feasibility outcomes involved eligibility rate, recruitment speed, uptake, retention, treatment adherence, and dropout, clinical outcomes included sleep quality (PSQI), PTSD symptoms (PSSI-5), distress (PSS-10), and well-being (WHO-5). Results: Outcome data were provided by 96.8 %; eligibility rate was 75.6 %; 31 patients were recruited within 6 months; uptake and retention were 100 %; treatment adherence was 93.8 % in the intervention and 92.9 % in the active control group; dropout was 0 %. Distress decreased significantly more in the intervention group compared to the active control group (SMD = 0.67, 95 % CI 0.39, 0.94), but sleep quality, PTSD symptoms, and well-being did not improve significantly more. Conclusions: The use of a 4-week breath robot intervention was feasible and highly accepted in patients with severe PTSD. The breath robot intervention may reduce distress but may not be superior to a robot intervention without breath simulation for improving sleep and PTSD symptoms. Future trials should further determine the intervention’s clinical benefit.