Mindfulness Meditation Mobile App Improves Depression and Anxiety in Adults with Sleep Disturbance: A Secondary Analysis of a Randomized Controlled Trial

Abstract

Background: The purpose of the study was to present secondary data analyses of an 8-week randomized controlled trial to: 1) Determine the effects of a meditation app on depression and anxiety in adults with sleep disturbance and 2) Explore the potential mediating effect of fatigue and daytime sleepiness on the relationship between use of the app and depression and anxiety. Methods: Depression, anxiety, fatigue, and daytime sleepiness were assessed at baseline, mid-, and post-intervention in the intervention and waitlist control group. Repeated-measures ANCOVAs assessed intervention effects on depression and anxiety. Mediation models, using the PROCESS macro, were estimated using 5000 bootstrap samples. Per-protocol and intent-to-treat (ITT) analyses were conducted. Results: Intervention group participants (N=239) had more improvements in depression and anxiety as compared to the control group. Fatigue and daytime sleepiness fully mediated the association between study group and improvements in depression. Fatigue and daytime sleepiness partially meditated the association between study group and improvements in anxiety. Conclusions: A meditation app may improve depression and anxiety in adults with sleep disturbance with effects being driven by improvements in fatigue and daytime sleepiness. Future studies should consider targeting fatigue and daytime sleepiness to improve mental health in adults with sleep disturbance.