Effectiveness of Mobile Health-Delivered Cognitive Behavioural Therapy for Insomnia in Adults: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.
Yangxi Huang, Yongyang Yan, Jojo Yan Yan Kwok and 4 others
PMID 40525767WHAT IT FOUND
Mobile phone-delivered CBT-I reduced insomnia symptoms and improved sleep quality in adults, including people with other conditions.
Benefits were seen right after treatment and up to 6 months, but confidence in the results was low.
Key findings
01Across 16 randomised trials, mobile-delivered CBT-I reduced insomnia symptoms and improved sleep quality at post-intervention, at 1-3 month follow-up, and at 4-6 month follow-up.
02Sleep diary outcomes were less consistent: sleep onset latency, number of awakenings, time in bed and sleep efficiency improved at post-intervention, but total sleep time did not.
03mCBT-I delivered by healthcare professionals showed larger sleep-quality improvements than self-help programmes, but insomnia symptom reductions did not differ significantly between provider types.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Sixteen trials varied widely in participants, control condition, delivery mode, provider, CBT-I components and duration, and heterogeneity was not fully explained. Most outcomes were graded low or very low certainty by GRADE. Seven trials had some concerns about risk of bias and three trials had high risk of bias. Some subgroup analyses relied on a single study, so apparent differences may be chance. The search was limited to English and Chinese publications. Only two trials were conducted in lower-middle-income countries. Included trials did not report enough detail about intervention dose, such as number of sessions, duration and intensity, to analyse dose-response. Older adults were underrepresented, and long-term effects beyond the available follow-up were unclear. The total participant count is reported as 2146 in the results and 2126 in the discussion.
Declared interests
The authors declared no conflicts of interest. They also disclosed using ChatGPT 4.0 to improve writing clarity after the first draft, with authors reviewing and editing the content.
The easy way to misread this
Do not read the significant pooled effect as high-certainty proof that mobile CBT-I works for every adult with insomnia. Most outcomes were graded low or very low certainty, older adults were underrepresented, and total sleep time did not improve at post-intervention.