Table 5 Participant comments regarding their experiences and opinion of their intervention

“I know most things the program has discussed so far. At the moment the most helpful thing has been the sleep diary to know exactly how much I sleep.”

“Access to the community adds value because you know you are not alone.”

“The intervention has laid out sleep goals, however, yet to address back pain issues.”

“The Sleepio program is confusing. It has only asked me to fill in a sleep diary, which is logical, but after a week of doing this there has been no follow-up.”

“It’s early days but having some professional advice gives me some positivity towards assisting me find answers to why how & helping find the answers! I already feel as if there is a goal set in place to make this happen”

“Found it very helpful this far”

“At the moment I am still just creating a sleep diary so I am not sure what the ‘changes’ to my sleep behaviour I’m going to see.”

“As I have generally done lots of reading about sleep and how to get it I don’t think a newsletter intervention will help me improve my sleep as I have read the info in the first three newsletters in other formats.”

“I only received one newsletter and it had a couple of interesting facts/information but nothing I felt that would help me improve my sleep. I actually can’t even remember what that information is now so I guess I didn’t really absorb it.”

“Doesn’t seem like much of an intervention. Only some information (most of which general knowledge).”

“Intervention seems to be based on information on activities that I so far practice - regular bed times, no TV, electronic devices on in bedroom etc. So unsure of objectives of this style of intervention”

“I was skeptical at the start but when reading the facts they have changed my sleep habits a little”

“The information is good and reiterates things I have heard before about sleep but unless I’m missing something that’s all it is. It doesn’t ask me to put any particular strategies in place so unless I’m proactive about it and choose to make some changes myself it won’t help.”

“At this stage reading general information about sleep and some common sense suggestions isn’t necessarily improving my sleep. It’s making me more aware of sleep however not resolving any issues”

“The facts were interesting. The tiredness during the day information particularly related to me.”

“I was expecting more back specific related problem solving. The information you have put in the emails I already know about and it doesn’t fix or is related to my back sleeping problems”

“Room temperature- as per newsletter 1- good tip. I feel much better in the morning.”

“Unsure how reading about sleep issues helps me.”

“To date, the suggestions and information received is same or similar to that I’ve already had”

“I don’t feel that this is really going to work for me”

“I am not accessing any intervention. I’m only being given general information about sleep.”

“I’m not sure I’m getting all the information. I have opened the emails and found articles to read. I have read all of them but have not changed anything as I already had this information and was incorporating it into my routine. Is there something else I’m supposed to do?”

“The information provided is interesting and some of it I’ve not heard before but thus far I don’t find it helpful in dealing with my waking up with pain.”

“My lower back pain again in my opinion is directly linked to my sleeping issues of staying asleep.”

“I found the sleep restriction hard and had short naps most days but it didn’t stop me sleeping at night and when I didn’t nap I had longer periods of time when I slept with being restless.”

“I felt extremely fatigued undertaking the Sleepio course - more so than usual”

“Could not get the video to open so could not complete full study”

“I think I am concentrating a bit much on the sleep problem because I have to record every day. I usually try not to think about it so that it doesn’t become a problem.”

“Was skeptical regarding Sleepio but although couldn’t assist with discomfort in bed gave some useful strategies.”

“I feel the sleepio program has helped me as my back pain at night has decreased - the interventions to help with sleep help the back pain. I am pleased to have had the opportunity to go on the sleepio program and its outcome has been good for me. I will say that in the early weeks it was only the commitment to being a participant in a scientific trial that kept me going.”

“I am settling down to sleep much better now that I follow the relax procedure and focus on something pleasurable (walking through a garden).”

“My sleep has definitely improved over the 6 week period”

“I believe it has helped my understanding more of sleep patterns. I no longer stress at not getting enough sleep that night as I night catch up the following evening plus I enjoyed the interaction with the Professor [avatar]”

“The last week I have felt pain due I think to inflammation. This has had an impact on my sleep however overall I have experienced better sleep since being on the program”

“In my view the advice on the room set up, exercise and reduced intake of caffeine before bedtime assisted greatly in improving my sleep quality. I also try to sit less at the Office and is using as standing desk. The standing desk definitely has an impact on back pain”

“I will keep trying the techniques from the Prof [avatar] and see how they go”

“I actually found the newsletters very informative and I have put some into action. Like keeping more regular sleep patterns.”

“Although the information in the newsletter was interesting, with no requirement to take action it doesn’t really change anything. Much of the information I had heard at some point or other. I am aware of the effect that technology before bed has on sleep, and how exercise can aid both sleep and back pain, it’s the following through on those things consistently that I struggle with. I feel there had been a commitment required to implement changes in relation to some of those factors then I would have seen beneficial results.”

“Being control was not helpful to me, hope it was for the study.”

“The newsletter seemed like common sense - reading irrelevant facts and figures about sleep was not going to help the problem”

“I felt the tips on sleep were helpful, like going to bed at the same time, not being tempted to sleep during the day and the tips helped me to try and be more positive”

“It was fairly obvious I was in the control group as it was just random facts about sleep. Nothing that could help me and there was no request for to actually do anything to change my behaviour.”

The participant reported liking the interactiveness of the program, and mindfulness strategies, and the extra resources and forums Sleepio has.