Abstract
BACKGROUND: Sleep problems in children are strongly influenced by household lifestyle habits. Detailed advice to each family is needed to improve sleep habits. Previously, we developed an interactive sleep education app for smartphones named 'Nenne Navi(Ⓡ)' and confirmed its effectiveness in improving young children's sleep habits in one region in Japan. We aimed to verify its effectiveness in four regions in Japan where children's sleep habits may differ. METHODS: This study included 52 infants (mean: 20.58 months) and their caregivers recruited from one urban city and three regional cities in Japan. The effectiveness of 6-month usage of Nenne Navi(Ⓡ) on children's sleep and caregivers' stress of caregiving was assessed. RESULTS: The app had a 100 % adherence rate at 6 months of intervention. Improvement in wake-up times, sleep onset latency, and social jet lag was observed as previously reported. In addition, there was a reduction in awakenings during the night, and caregivers' mood regarding parenting improved. There were regional differences at baseline in children's age, percentage attending nursery school, mothers' employment status, and nuclear family structure. A main effect of areas was observed only for wake-up time standard deviation of children. CONCLUSIONS: The app shows promise for improving children's and caregivers' sleep habits in a wider area of Japan, even after 6 months of use. Furthermore, its use might reduce caregivers' parenting stress. It could be expected that Nenne Navi(Ⓡ) will be used as a parenting support tool to assist caregivers.