The following is a summary of the “Digital cognitive behavior therapy for insomnia improving sleep quality: a real-world study” published in the December 2022 issue of Psychiatry by Liang et al.

Insomnia treatments have come a long way, and digital cognitive behavior therapy for insomnia (dCBT-I) is among the most promising. In this study, the effectiveness of dCBT-I was tested in a clinical population with insomnia symptoms. About 6,002 participants, all adults, were recruited from a sleep clinic at a psychiatric hospital between November 2016 and April 2021, with primary symptoms of unsatisfactory sleep. According to the international classification of diseases (ICD)-10 diagnostic criteria, patients were diagnosed with insomnia, anxiety disorders, or anxiety co-occurring with insomnia or depression. 

A mobile app has been developed for self-report assessment and the distribution of dCBT-I treatments and treatment plans. Specifically, the Pittsburgh Sleep Quality Index (PSQI) was used to quantify improvement or decline in sleep quality on a global scale. About 509 individuals were evaluated again at 8 and 12 weeks. Repeated-measures data were examined using non-parametric tests. When compared to patients treated with medication monotherapy and those treated with a combination of dCBT-I and medication, patients treated with dCBT-I alone tended to be younger and more likely to have a family history of insomnia. There were statistically significant improvements in sleep quality across all therapy groups from baseline to the 8-week follow-up. Anxiety patients treated with dCBT-I monotherapy and those treated with combined therapy showed substantial improvements in PSQI ratings at 12 weeks compared to 8 weeks. 

Patient anxiety patients showed a time-by-treatment interaction, suggesting that some treatments were more effective than others at lowering PSQI ratings over time. The results of the current study support the use of dCBT-I for the treatment of insomnia, particularly in patients who also suffer from anxiety symptoms and who may benefit from a longer intervention period (i.e., 12 weeks).