Innovative Digital Cognitive Behavioral Treatment for Insomnia Disorder in Adults (dCBT-i): Framework Development

Chronic insomnia, or insomnia disorder, is a major health issue with a prevalence of up to 15%. The recommended first-line treatment is cognitive behavioral therapy for insomnia (CBT-i), which, unfortunately, remains insufficiently accessible. Digitalization has the potential to reduce health care access inequalities by offering more flexible and accessible care options. Digital CBT-i (dCBT-i) has been shown to be as effective as in-person CBT-i, highlighting its potential for broader implementation.

This study aimed to develop an evidence-based dCBT-i program grounded in theoretical and clinical knowledge, designed for efficient integration into health care systems, and to establish it as the first prescribed digital treatment in France.

The program was constructed based on validated CBT-i theory and practice, incorporating the latest scientific data on CBT for insomnia. It was designed as a robust multicomponent therapy, integrating an initial standardized assessment and daily intelligent adaptation to enable digital phenotyping and provide personalized treatment.

We developed an innovative digital solution that combines scientific rigor with practical application. The program includes a standardized initial evaluation and dynamic personalization through intelligent algorithms. These features allow for the adaptation of therapy based on patient progress and needs, ensuring individualized care.

The development of this dCBT-i program represents a significant milestone in digital health care, offering a scalable solution to the accessibility challenges of traditional CBT-i. Future steps involve conducting clinical studies to further evaluate its effectiveness and optimize its implementation within health care systems.