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

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.