Swipe for sleep - a standardized evaluation of mobile health apps for insomnia in children and adolescents

Abstract

Introduction

Access to cognitive behavioral therapy for insomnia (CBT-I) in children and adolescents is limited. Mobile health applications (MHAs) available in app stores may provide an accessible and scalable option for delivering CBT-I. This study systematically evaluated the quality of MHAs targeting insomnia in children and adolescents and examined their evidence base and treatment components.

Methods

In November 2024, a systematic search of the Google Play and Apple App Stores was conducted to identify MHAs targeting insomnia in children and adolescents. MHAs were screened for eligibility in a two-level process: first based on app store descriptions, then after downloading the MHA. Eligible MHAs were independently evaluated using the German Mobile Application Rating Scale (MARS-G), which rates MHAs from 1 (inadequate) to 5 (excellent) across the subscales engagement, functionality, aesthetics, and information. Additionally, the featured treatment components and supporting scientific evidence were assessed.

Results

Of 2341 MHAs initially identified, eight MHA products met the inclusion criteria. The overall quality was moderate (mean = 3.5, SD = 0.4). Among the subscales, functionality was rated highest (mean = 3.8, SD = 0.6), followed by aesthetics (mean = 3.6, SD = 0.6), engagement (mean = 3.3, SD = 0.4), and information (mean = 3.1, SD = 0.8). Sleep hygiene was the most commonly featured treatment component (seven MHA products). While scientific evidence was identified for five MHA products, none specifically evaluated insomnia in the target population.

Conclusion

Although many MHAs claim to target sleep in children and adolescents, few incorporate CBT-I components beyond sleep hygiene. The moderate quality and limited evidence base underscore the need for theory-driven, rigorously evaluated MHAs tailored to this age group.