Sleep

Assessing the Feasibility, Usability, Acceptability, and Efficacy of an AI Chatbot for Sleep Promotion: Quasi-Experimental Study.

TL;DR

An AI sleep chatbot demonstrated satisfactory feasibility, usability, and acceptability, with preliminary evidence showing improved sleep outcomes including increased total sleep time by 1.4 hours and decreased sleep onset latency by 30.9 minutes, although causality cannot be established.

Key Findings

The AI sleep chatbot showed satisfactory feasibility, with 82.2% of enrolled adults completing chatbot registration, 73.9% initiating interactions, and 50% completing the 2-week intervention.

  • 107 adults enrolled in the study; 88 (82.2%) completed chatbot registration
  • 65 of 88 registered participants (73.9%) initiated interactions with the chatbot
  • 44 of 88 registered participants (50%) completed the full 2-week intervention
  • Final analysis included 42 adults (mean age 36, SD 11 years; 28.6% male)
  • The chatbot was integrated into a commercially available messaging app

Participants engaged with the chatbot for an average of 58 minutes total over the 2-week period, with each chat session lasting approximately 9 minutes.

  • Average total engagement time was 58 (SD 42) minutes
  • Each chat session lasted approximately 9 (SD 6) minutes
  • Participants interacted via texting with a virtual sleep therapist over 2 weeks
  • The chatbot provided individualized sleep guidance and adapted recommendations based on prior conversations

The chatbot received high usability ratings, with an average System Usability Scale score of 85.2 out of 100, well above the benchmark score of 68.

  • Average usability score was 85.2 (SD 10.7) out of 100
  • Score exceeded the established benchmark of 68
  • Most participants reported favorable experiences with the chatbot
  • Feasibility, usability, and acceptability were descriptively summarized

The chatbot was rated as highly acceptable, with a satisfaction score of 27.3 out of 32, and all participants perceived the chatbot as effective.

  • Satisfaction score was 27.3 (SD 4.1) out of a maximum of 32
  • All participants perceived the chatbot as effective
  • Effectiveness ratings ranged from 'slightly effective' to 'extremely effective'
  • Most participants reported favorable experiences with the chatbot overall

Total sleep time increased by 1.4 hours and sleep onset latency decreased by 30.9 minutes following the 2-week chatbot intervention.

  • Total sleep time increased by 1.4 hours (P<.001)
  • Sleep onset latency decreased by 30.9 minutes (P<.001)
  • Sleep was assessed using questionnaires before and after the intervention
  • The study was quasi-experimental with a single group, so causality cannot be established

Sleep efficiency increased by 7.8% and multiple subjective sleep measures showed statistically significant improvement following chatbot use.

  • Sleep efficiency increased by 7.8% (P=.007)
  • Perceived sleep quality improved with a mean difference of -5.4 (P<.001)
  • Insomnia severity improved with a mean difference of -7.9 (P<.001)
  • Daytime sleepiness improved with a mean difference of -4.7 (P<.001)
  • Sleep hygiene skills improved with a mean difference of -13.2 (P<.001)

No significant change was observed in sleep environment scores following the chatbot intervention.

  • Sleep environment mean difference was -1.1 (P=.16), which was not statistically significant
  • This was the only sleep-related outcome that did not show significant improvement
  • All other assessed sleep outcomes showed statistically significant improvements

The study was a quasi-experimental, single-group design without a control group, limiting causal conclusions about the chatbot's efficacy.

  • Design was described as 'quasi-experimental, single-group study'
  • Authors stated 'causality cannot be established'
  • Sleep outcomes were assessed only via self-report questionnaires; no objective sleep measurements were used
  • Authors recommend future randomized controlled trials and objective sleep measurements to validate findings
  • Participants were adults aged 18 to 75 years in the United States who self-reported poor sleep

What This Means

This research suggests that an AI-powered chatbot designed to improve sleep may be a feasible, easy-to-use, and acceptable tool for people who struggle with poor sleep. In the study, 107 American adults with self-reported poor sleep were asked to text with a virtual sleep therapist powered by a large language model for two weeks. About half of those who registered finished the full program, and those who did reported high satisfaction and rated the chatbot as effective. Participants spent an average of about an hour total chatting with the bot across the two weeks, in sessions averaging around nine minutes each. Among the 42 participants included in the final analysis, sleep improved substantially across nearly all measures after using the chatbot. On average, people slept 1.4 more hours per night, fell asleep about 31 minutes faster, and had better sleep efficiency. They also reported less severe insomnia, less daytime sleepiness, better perceived sleep quality, and improved sleep hygiene habits. The only measure that did not show a statistically significant change was the sleep environment score. This research suggests that AI chatbots built on large language models could be a low-cost, accessible way to deliver personalized sleep support at scale. However, because the study had no control group and relied entirely on self-reported sleep data, it is not possible to say the chatbot definitively caused these improvements. The authors call for future randomized controlled trials and studies using objective sleep tracking devices to confirm these promising early findings.

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Citation

Liu X, Liu J. (2026). Assessing the Feasibility, Usability, Acceptability, and Efficacy of an AI Chatbot for Sleep Promotion: Quasi-Experimental Study.. JMIR formative research. https://doi.org/10.2196/84023