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Digital App Based Cognitive Behaviour Therapy CBT-I Course Improving Insomnia and Sleep Hygiene: A Randomised
Maren-Jo Kater1, Nina Wegener2, Nicolas Morath3
1Developmental Psychology and Developmental Psychopathology, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany.
Journal of Sleep Research
|October 1, 2025
Summary
This study shows that an app-based cognitive behavioural therapy for insomnia (CBT-I) course significantly reduced insomnia severity and improved sleep hygiene. Many users reported sustained sleep improvements, demonstrating the intervention
Area of Science:
- Digital Health Interventions
- Sleep Medicine
- Cognitive Behavioral Therapy
Background:
- Sleep initiation and maintenance problems are prevalent, exceeding 50% in some surveys.
- Preventing chronic insomnia can reduce healthcare costs and secondary illnesses.
- Sub-threshold to moderate insomnia symptoms represent a critical window for intervention.
Purpose of the Study:
- To evaluate the effectiveness of a novel app-based digital course utilizing cognitive behavioral therapy for insomnia (CBT-I).
- To assess the intervention's efficacy in preventing the manifestation of insomnia in individuals with sub-threshold to moderate symptoms.
- To examine the long-term maintenance of treatment effects at a 3-month follow-up.
Main Methods:
- A randomized controlled trial comparing an app-based CBT-I intervention group (N=191) to a waitlist control group (N=72).
- Participants aged 20-77 were assessed at baseline, post-intervention (7 weeks), and 3-month follow-up.
- Outcome measures included the Insomnia Severity Index (ISI), Sleep Hygiene Index (SHI), and sleep diary entries.
Main Results:
- Significant reductions in insomnia severity (ISI: -4.8 points) and improvements in sleep hygiene (SHI: -3.5 points) were observed post-intervention (p<0.001).
- Remission rates were higher in the intervention group (48%) compared to the control group (18%).
- Improvements in sleep latency, efficiency, and reductions in nocturnal awakenings were sustained at 3-month follow-up, with 68% of users reporting sustained benefits.
Conclusions:
- An app-based CBT-I intervention is effective in reducing insomnia severity and improving sleep hygiene in individuals with sub-threshold to moderate symptoms.
- The intervention demonstrates sustained effects at 3-month follow-up, indicating its potential for long-term sleep health management.
- Digital CBT-I interventions can successfully modify various sleep hygiene behaviors, offering a scalable solution for sleep problems.
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