Efficacy of internet-delivered cognitive-behavioral therapy for insomnia— a systematic review and meta-analysis of randomized controlled trials

Zachariae, Robert; Lyby, Marlene S.; Ritterband, Lee M.; O'Toole, Mia S.

doi:10.1016/j.smrv.2015.10.004

Cited by 704Sleep and related disordersDigital Mental Health InterventionsObstructive Sleep Apnea Research

Efficacy of internet-delivered cognitive-behavioral therapy for insomnia— a systematic review and meta-analysis of randomized controlled trials

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Zachariae, Robert, Lyby, Marlene S., Ritterband, Lee M., O'Toole, Mia S.·2016·Sleep Medicine Reviews

DOI 10.1016/j.smrv.2015.10.004

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Abstract

Cognitive-behavioral therapy for insomnia (CBT-I) has been shown efficacious, but the challenge remains to make it available and accessible in order to meet population needs. Delivering CBT-I over the internet (eCBT-I) may be one method to overcome this challenge. The objective of this meta-analysis was to evaluate the efficacy of eCBT-I and the moderating influence of various study characteristics. Two researchers independently searched key electronic databases (1991 to June 2015), selected eligible publications, extracted data, and evaluated methodological quality. Eleven randomized controlled trials examining a total of 1460 participants were included. Results showed that eCBT-I improved insomnia severity, sleep efficiency, subjective sleep quality, wake after sleep onset, sleep onset latency, total sleep time, and number of nocturnal awakenings at post-treatment, with effect sizes (Hedges's g) ranging from 0.21 to 1.09. The effects were comparable to those found for face-to-face CBT-I, and were generally maintained at 4-48 wk follow-up. Moderator analyses showed that longer treatment duration and higher degree of personal clinical support were associated with larger effect sizes, and that larger study dropout in the intervention group was associated with smaller effect sizes. In conclusion, internet-delivered CBT-I appears efficacious and can be considered a viable option in the treatment of insomnia.

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Freeman, D., Sheaves, B., Goodwin, G. M., Yu, L.-M., Nickless, A., Harrison, P. J., Emsley, R., Luik, A. I., Foster, R. G., Wadekar, V., et al. (2017) · The Lancet Psychiatry · doi:10.1016/s2215-0366(17)30328-0 · Cited by 652 · see citing works
The impact of stress on sleep: pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders
Kalmbach, D. A., Anderson, J. R., & Drake, C. L. (2018) · Journal of Sleep Research · doi:10.1111/jsr.12710 · Cited by 620 · see citing works
Effect of Digital Cognitive Behavioral Therapy for Insomnia on Health, Psychological Well-being, and Sleep-Related Quality of Life: A Randomized Clinical Trial
Espie, C. A., Emsley, R., Kyle, S. D., Gordon, C., Drake, C. L., Siriwardena, A. N., Cape, J., Ong, J. C., Sheaves, B., Foster, R., et al. (2019) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2018.2745 · Cited by 466 · see citing works
Efficacy of digital cognitive behavioural therapy for insomnia: a meta-analysis of randomised controlled trials
Soh, H. L., Ho, R. C., Ho, C. S., & Tam, W. W. (2020) · Sleep Medicine · doi:10.1016/j.sleep.2020.08.020 · Cited by 482 · see citing works
An overview of and recommendations for more accessible digital mental health services
Lattie, E. G., Stiles-Shields, C., & Graham, A. K. (2022) · Nature Reviews Psychology · doi:10.1038/s44159-021-00003-1 · Cited by 446 · see citing works
Internet- and Mobile-Based Psychological Interventions: Applications, Efficacy, and Potential for Improving Mental Health: A Report of the EFPA E-Health Taskforce
Ebert, D. D., Van Daele, T., Nordgreen, T., Karekla, M., Compare, A., Zarbo, C., Brugnera, A., Øverland, S., Trebbi, G., Jensen, K. L., et al. (2018) · European Psychologist · doi:10.1027/1016-9040/a000318 · Cited by 437 · see citing works
“…alcohol consumption (Riper et al., 2014), improving sleep (Ebert, Berking, Thiart, et al., 2015; Thiart, Lehr, Ebert, Berking, & Riper, 2015; Zachariae et al., 2015), reducing work-related European Psychologist (2018), 23(2), 167–187 2018 Hogrefe Publishing 174 D. D. Ebert et al., Internet-…”
Influential
Standalone smartphone apps for mental health—a systematic review and meta-analysis
Weisel, K. K., Fuhrmann, L. M., Berking, M., Baumeister, H., Cuijpers, P., & Ebert, D. D. (2019) · npj Digital Medicine · doi:10.1038/s41746-019-0188-8 · Cited by 447 · see citing works
The Handbook of Behavior Change
Hagger, M. S., Cameron, L. D., Hamilton, K., Hankonen, N. E., & Lintunen, T. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318 · Cited by 420 · see citing works
Internet-Delivered Cognitive Behavioral Therapy to Treat Insomnia: A Systematic Review and Meta-Analysis.
Seyffert, M., Lagisetty, P., Landgraf, J., Chopra, V., Pfeiffer, P. N., Conte, M. L., & Rogers, M. A. M. (2016) · PLOS ONE · doi:10.1371/journal.pone.0149139 · Cited by 323 · see citing works
“Zachariae and colleagues reviewed evidence from 11 randomized trials (1460 participants) and also reported similar results [13].”
BackgroundMethodResultInfluential
Insomnia disorder: State of the science and challenges for the future
Riemann, D. W., Benz, F., Dressle, R. J., Espie, C. A., Johann, A. F., Blanken, T. F., Leerssen, J., Wassing, R., Henry, A. L., Kyle, S. D., et al. (2022) · Journal of Sleep Research · doi:10.1111/jsr.13604 · Cited by 368 · see citing works
“Several meta-analyses report large between-group effects on insomnia severity, and medium effects on sleep diary outcomes (Seyffert et al., 2016; Soh et al., 2020; Zachariae et al., 2016), and benefits to sleep are durable,”
Background
S3-Leitlinie Nicht erholsamer Schlaf/Schlafstörungen
Riemann, D. W., Baum, E., Cohrs, S., Crönlein, T., Hajak, G., Hertenstein, E., Klose, P., Langhorst, J., Mayer, G., Nissen, C., et al. (2017) · Somnologie - Schlafforschung und Schlafmedizin · doi:10.1007/s11818-016-0097-x · Cited by 339 · see citing works
Hyperarousal and sleep reactivity in insomnia: current insights
Kalmbach, D. A., Cuamatzi-Castelan, A. S., Tonnu, C. V., Tran, K. M., Anderson, J. R., Roth, T. G., & Drake, C. L. (2018) · Nature and Science of Sleep · doi:10.2147/nss.s138823 · Cited by 343 · see citing works
Clarifying the Concept of Adherence to eHealth Technology: Systematic Review on When Usage Becomes Adherence
Sieverink, F., Kelders, S. M., & van Gemert-Pijnen, J. E. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.8578 · Cited by 331 · see citing works
“Although a longer treatment duration is associated with better effects [80], this still implies that users do not necessarily need to finish the complete program to experience reduction of their complaints, and that there should be a threshold for intended use.”
Background
Effect of a Web-Based Cognitive Behavior Therapy for Insomnia Intervention With 1-Year Follow-up: A Randomized Clinical Trial
Ritterband, L. M., Thorndike, F. P., Ingersoll, K. S., Lord, H. R., Gonder-Frederick, L., Frederick, C., Quigg, M. S., Cohn, W. F., & Morin, C. M. (2017) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2016.3249 · Cited by 325 · see citing works
“Years of sleep problems, median (IQR) 7 (4-10) 10 (5-15) 9 (5-15) z = 2.”
British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: an update
Wilson, S., Anderson, K., Baldwin, D., Dijk, D.-J., Espie, A., Espie, C., Gringras, P., Krystal, A., Nutt, D., Selsick, H., et al. (2019) · Journal of Psychopharmacology · doi:10.1177/0269881119855343 · Cited by 312 · see citing works
Evidence-Based Psychosocial Treatments for Self-Injurious Thoughts and Behaviors in Youth
Glenn, C. R., Franklin, J. C., & Nock, M. K. (2015) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2014.945211 · Cited by 288 · see citing works
Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment
Edinger, J. D., Arnedt, J. T., Bertisch, S. M., Carney, C. E., Harrington, J. J., Lichstein, K. L., Sateia, M. J., Troxel, W. M., Zhou, E. S., Kazmi, U., et al. (2021) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.8988 · Cited by 309 · see citing works
Changing Behavior Using the Theory of Planned Behavior
Ajzen, I., & Schmidt, P. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.002 · Cited by 303 · see citing works
Prevention of mental health disorders using internet and mobile-based interventions: a narrative review and recommendations for future research.
Ebert, D. D., Cuijpers, P., Muñoz, R. F., & Baumeister, H. (2017) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2017.00116 · Cited by 244 · see citing works
Internet-delivered health interventions that work: systematic review of meta-analyses and evaluation of website availability
Rogers, M. A., Lemmen, K., Kramer, R., Mann, J., & Chopra, V. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7111 · Cited by 259 · see citing works
“There were 71 meta-analyses of Internet-based interventions that met eligibility criteria and were included in this study [7-76].”
Internet-Delivered Cognitive-Behavioral Therapy for Insomnia in Breast Cancer Survivors: A Randomized Controlled Trial
Zachariae, R., Amidi, A., Damholdt, M. F., Clausen, C. D. R., Dahlgaard, J., Lord, H., Thorndike, F. P., & Ritterband, L. M. (2018) · JNCI: Journal of the National Cancer Institute · doi:10.1093/jnci/djx293 · Cited by 212 · see citing works
“The study dropout rates of 22.6% and 18.1% in the intervention and control groups, respectively, are comparable to the average study dropout of 24.7% found in previous iCBT-Is with general population samples (18) and dropout rates of up to 33% found in face-to-face-delivered CBT-I (13).”
BackgroundResultInfluentialSelf-citation
Evidence Base Update of Psychosocial Treatments for Self-Injurious Thoughts and Behaviors in Youth
Glenn, C. R., Esposito, E. C., Porter, A. C., & Robinson, D. J. (2019) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2019.1591281 · Cited by 219 · see citing works
A systematic review and meta-analysis of cognitive and behavioral interventions to improve sleep health in adults without sleep disorders
Murawski, B., Wade, L., Plotnikoff, R. C., Lubans, D. R., & Duncan, M. J. (2017) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2017.12.003 · Cited by 225 · see citing works
Validation of the Sleep Regularity Index in Older Adults and Associations with Cardiometabolic Risk
Lunsford‐Avery, J. R., Engelhard, M., Návar, A. M., & Kollins, S. H. (2018) · Scientific Reports · doi:10.1038/s41598-018-32402-5 · Cited by 222 · see citing works
Efficacy and safety of acupuncture treatment on primary insomnia: a randomized controlled trial.
Yin, X., Gou, M., Xu, J., Dong, B., Yin, P., Masquelin, F., Wu, J.-Y., Lao, L., & Xu, S.-F. (2017) · Sleep Medicine · doi:10.1016/j.sleep.2017.02.012 · Cited by 205 · see citing works
Cognitive behavioral therapy for insomnia in patients with chronic pain-A systematic review and meta-analysis of randomized controlled trials
Selvanathan, J., Pham, C., Nagappa, M., Peng, P. W. H., Englesakis, M., Espie, C. A., Morin, C. M., & Chung, F. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2021.101460 · Cited by 206 · see citing works
Efficacy of digital CBT for insomnia to reduce depression across demographic groups: a randomized trial
Cheng, P., Luik, A. I., Fellman-Couture, C., Peterson, E. L., Joseph, C. L. M., Tallent, G., Tran, K. M., Ahmedani, B. K., Roehrs, T., Roth, T. G., et al. (2018) · Psychological Medicine · doi:10.1017/s0033291718001113 · Cited by 183 · see citing works
“Though dCBT-I is still nascent, support for its efficacy has been accumulating from randomized controlled trials comparing it with an attention control or face-to-face CBT-I (Ström et al. 2004; Ritterband et al. 2009, 2017; Espie et al. 2012; Zachariae et al. 2016).”
Background
Effects of cognitive behavioral therapy for insomnia (CBT-I) on quality of life: A systematic review and meta-analysis
Alimoradi, Z., Jafari, E., Broström, A., Ohayon, M. M., Lin, C., Griffiths, M. D., Blom, K., Jernelöv, S., Kaldo, V., & Pakpour, A. H. (2022) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2022.101646 · Cited by 178 · see citing works
Sleep Disorders, Restless Legs Syndrome, and Uremic Pruritus: Diagnosis and Treatment of Common Symptoms in Dialysis Patients
Scherer, J. S., Combs, S., & Brennan, F. P. (2016) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2016.07.031 · Cited by 166 · see citing works
A randomized controlled trial of digital cognitive behavioral therapy for insomnia in pregnant women
Kalmbach, D. A., Cheng, P., O'Brien, L. M., Swanson, L. M., Sangha, R., Sen, S., Guille, C., Cuamatzi-Castelan, A., Henry, A. L., Roth, T., et al. (2020) · Sleep Medicine · doi:10.1016/j.sleep.2020.03.016 · Cited by 154 · see citing works
“As digital CBTI has proven highly efficacious at improving sleep in broader adult populations [40], leveraging this technology to increase reach and accessibility of insomnia care for pregnant women has immense potential to improve sleep and mental wellbeing in this vulnerable population.”
Background
Mobile phone-delivered cognitive behavioral therapy for insomnia: a randomized waitlist controlled trial
Horsch, C. H., Lancee, J., Griffioen-Both, F., Spruit, S., Fitrianie, S., Neerincx, M. A., Beun, R. J., & Brinkman, W.-P. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.6524 · Cited by 164 · see citing works
“Zachariae and colleagues [16] found in their meta-analysis that 58.”
Advances in the management of chronic insomnia
Kay-Stacey, M., & Attarian, H. P. (2016) · BMJ · doi:10.1136/bmj.i2123 · Cited by 163 · see citing works
Digital Cognitive Behavioral Therapy (dCBT) for Insomnia: a State-of-the-Science Review
Luik, A. I., Kyle, S. D., & Espie, C. A. (2017) · Current Sleep Medicine Reports · doi:10.1007/s40675-017-0065-4 · Cited by 156 · see citing works
Efficacy of cognitive behavioral therapy for insomnia in breast cancer: A meta-analysis
Ma, Y., Hall, D. L., Ngo, L. H., Liu, Q., Bain, P. A., & Yeh, G. Y. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2020.101376 · Cited by 151 · see citing works
Depression prevention via digital cognitive behavioral therapy for insomnia: a randomized controlled trial
Cheng, P., Kalmbach, D. A., Tallent, G., Joseph, C. L. M., Espie, C. A., & Drake, C. L. (2019) · SLEEP · doi:10.1093/sleep/zsz150 · Cited by 159 · see citing works
“supported the short-term effectiveness of dCBT-I for both insomnia [23, 24, 28] and depression [17, 29, 30].”
Background
The role of sleep in bipolar disorder
Gold, A. K., & Sylvia, L. G. (2016) · Nature and Science of Sleep · doi:10.2147/nss.s85754 · Cited by 147 · see citing works
“Zachariae et al 86 conducted a meta-analysis of Internet-delivered cognitive behavioral therapy for insomnia (eCBT-I) with findings indicating that eCBT-I was effective in improving self-reported sleep quality, sleep onset latency, sleep efficiency, and total sleep time among individuals with…”
Influential
Changing Behavior Using the Model of Action Phases
Keller, L., Gollwitzer, P. M., & Sheeran, P. (2020) · The Handbook of Behavior Change · doi:10.1017/9781108677318.006 · Cited by 147 · see citing works
Cognitive Behavioral Therapy for Prenatal Insomnia: A Randomized Controlled Trial
Manber, R., Bei, B., Simpson, N., Asarnow, L., Rangel, E., Sit, A., & Lyell, D. (2019) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000003216 · Cited by 145 · see citing works
Australasian Sleep Association position statement regarding the use of psychological/behavioral treatments in the management of insomnia in adults
Ree, M., Junge, M., & Cunnington, D. (2017) · Sleep Medicine · doi:10.1016/j.sleep.2017.03.017 · Cited by 145 · see citing works
The efficacy of cognitive and behavior therapies for insomnia on daytime symptoms: a systematic review and network meta-analysis
Benz, F., Knoop, T., Ballesio, A., Bacaro, V., Johann, A. F., Rücker, G., Feige, B., Riemann, D., & Baglioni, C. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101873 · Cited by 142 · see citing works
Comparative effectiveness and safety of pharmacological and non-pharmacological interventions for insomnia: an overview of reviews
Rios, P. D. L., Cardoso, R., Morra, D. E., Nincic, V., Goodarzi, Z., Farah, B., Harricharan, S., Morin, C. M., Leech, J. A., Straus, S. E., et al. (2019) · Systematic Reviews · doi:10.1186/s13643-019-1163-9 · Cited by 141 · see citing works
Comparative efficacy of digital cognitive behavioral therapy for insomnia: A systematic review and network meta-analysis
Hasan, F., Tu, Y.-K., Yang, C.-M., James Gordon, C., Wu, D., Lee, H.-C., Yuliana, L. T., Herawati, L., Chen, T.-J., & Chiu, H.-Y. (2022) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2021.101567 · Cited by 137 · see citing works
Heart rate variability in insomnia patients: A critical review of the literature
Dodds, K. L., Miller, C. B., Kyle, S. D., Marshall, N. S., & Gordon, C. J. (2016) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2016.06.004 · Cited by 134 · see citing works
Comparative efficacy of onsite, digital, and other settings for cognitive behavioral therapy for insomnia: a systematic review and network meta-analysis
Simon, L., Steinmetz, L., Feige, B., Benz, F., Spiegelhalder, K., & Baumeister, H. (2023) · Scientific Reports · doi:10.1038/s41598-023-28853-0 · Cited by 135 · see citing works
“Guidance might be an important factor in bibliotherapy Our analyses and current evidence 14–17 indicate that guided and unguided iCBT-I should be considered to improve the dissemination of CBT-I in routine care.”
Sleep Disturbances and Atopic Dermatitis: Relationships, Methods for Assessment, and Therapies
Bawany, F., Northcott, C. A., Beck, L. A., & Pigeon, W. R. (2020) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2020.12.007 · Cited by 134 · see citing works
Management of Insomnia
Morin, C. M., & Buysse, D. J. (2024) · New England Journal of Medicine · doi:10.1056/nejmcp2305655 · Cited by 169 · see citing works
Banbury forum consensus statement on the path forward for digital mental health treatment
Mohr, D. C., Azocar, F., Bertagnolli, A., Choudhury, T., Chrisp, P., Frank, R., Harbin, H., Histon, T., Kaysen, D., Nebeker, C., et al. (2021) · Psychiatric Services · doi:10.1176/appi.ps.202000561 · Cited by 115 · see citing works
Public attitudes toward guided internet-based therapies: web-based survey study
Apolinário-Hagen, J., Harrer, M., Kählke, F., Fritsche, L., Salewski, C., & Ebert, D. D. (2018) · JMIR Mental Health · doi:10.2196/10735 · Cited by 123 · see citing works
“In recent years, a large number of randomized controlled trials have shown that internet interventions can effectively treat various mental health disorders, such as depression [13,14], anxiety [15-17], insomnia [18], alcohol use disorder [19], comorbid mental health problems in chronic somatic diseases [20,21], and p…”
Background
Effects of digital cognitive behavioural therapy for insomnia on insomnia severity: a large-scale randomised controlled trial
Vedaa, Ø., Kallestad, H., Scott, J. L., Smith, O. R. F., Pallesen, S., Morken, G., Langsrud, K., Gehrman, P., Thorndike, F. P., Ritterband, L. M., et al. (2020) · The Lancet Digital Health · doi:10.1016/s2589-7500(20)30135-7 · Cited by 118 · see citing works
Changes in dysfunctional beliefs about sleep after cognitive behavioral therapy for insomnia: A systematic literature review and meta-analysis
Thakral, M., Von Korff, M., McCurry, S. M., Morin, C. M., & Vitiello, M. V. (2020) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2019.101230 · Cited by 117 · see citing works
Internet-Based Cognitive Behavioral Therapy for Insomnia: A Health Economic Evaluation
Thiart, H., Ebert, D. D., Lehr, D., Nobis, S., Buntrock, C., Berking, M., Smit, F., & Riper, H. M. (2016) · SLEEP · doi:10.5665/sleep.6152 · Cited by 111 · see citing works
Does online insomnia treatment reduce depressive symptoms? A randomized controlled trial in individuals with both insomnia and depressive symptoms
van der Zweerde, T., van Straten, A., Effting, M., Kyle, S. D., & Lancee, J. (2018) · Psychological Medicine · doi:10.1017/s0033291718001149 · Cited by 109 · see citing works
Changing Behavior Using the Health Action Process Approach
Schwarzer, R., & Hamilton, K. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.007 · Cited by 107 · see citing works
Telemedicine versus face-to-face delivery of cognitive behavioral therapy for insomnia: a randomized controlled noninferiority trial
Arnedt, J. T., Conroy, D. A., Mooney, A., Furgal, A. K. C., Sen, A., & Eisenberg, D. (2020) · SLEEP · doi:10.1093/sleep/zsaa136 · Cited by 109 · see citing works
Group vs. Individual Treatment for Acute Insomnia: A Pilot Study Evaluating a “One-Shot” Treatment Strategy
Boullin, P., Ellwood, C., & Ellis, J. G. (2016) · Brain Sciences · doi:10.3390/brainsci7010001 · Cited by 108 · see citing works
Non-pharmacological Approaches for Management of Insomnia
Chan, N. Y., Chan, J. W. Y., Li, S. X., & Wing, Y. K. (2021) · Neurotherapeutics · doi:10.1007/s13311-021-01029-2 · Cited by 117 · see citing works
Three-Year Follow-Up Comparing Cognitive Behavioral Therapy for Depression to Cognitive Behavioral Therapy for Insomnia, for Patients With Both Diagnoses
Blom, K., Jernelöv, S., Rück, C., Lindefors, N., & Kaldo, V. (2017) · SLEEP · doi:10.1093/sleep/zsx108 · Cited by 102 · see citing works
Proof of Concept for an Adaptive Treatment Strategy to Prevent Failures in Internet-Delivered CBT: A Single-Blind Randomized Clinical Trial With Insomnia Patients
Forsell, E., Jernelöv, S., Blom, K., Kraepelien, M., Svanborg, C., Andersson, G., Lindefors, N., & Kaldo, V. (2019) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2018.18060699 · Cited by 100 · see citing works
Improvements of adolescent psychopathology after insomnia treatment: results from a randomized controlled trial over 1 year
de Bruin, E. J., Bögels, S. M., Oort, F. J., & Meijer, A. M. (2018) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12834 · Cited by 95 · see citing works
Pilot evaluation of the Sleep Ninja: A smartphone application for adolescent insomnia symptoms
Werner-Seidler, A., Wong, Q., Johnston, L., O’Dea, B., Torok, M., & Christensen, H. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-026502 · Cited by 82 · see citing works
A single arm pilot trial of brief cognitive behavioral therapy for insomnia in adolescents with physical and psychiatric comorbidities
Palermo, T. M., Beals-Erickson, S., Bromberg, M., Law, E., & Chen, M. (2017) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.6490 · Cited by 92 · see citing works
Insomnia in adult patients with cancer: ESMO Clinical Practice Guideline
Grassi, L., Zachariae, R., Caruso, R., Palagini, L., Campos-Ródenas, R., Riba, M. B., Lloyd-Williams, M., Kissane, D., Rodin, G., McFarland, D., et al. (2023) · ESMO Open · doi:10.1016/j.esmoop.2023.102047 · Cited by 96 · see citing works
Economic Evaluation of Cognitive Behavioural Therapy for Insomnia (CBT-I) for Improving Health Outcomes in Adult Populations: A Systematic Review
Natsky, A. N., Vakulin, A., Chai-Coetzer, C. L., Lack, L., McEvoy, R. D., Lovato, N., Sweetman, A., Gordon, C. J., Adams, R. J., & Kaambwa, B. (2020) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2020.101351 · Cited by 91 · see citing works
Randomized Controlled Trial to Test the Efficacy of an Unguided Online Intervention with Automated Feedback for the Treatment of Insomnia
Lorenz, N., Heim, E., Rötger, A., Birrer, E., & Maercker, A. R. A. (2018) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465818000486 · Cited by 90 · see citing works
“One meta-analysis found eleven published randomized controlled trials (RCTs) which had tested the effect of internet-delivered CBT-I (Zachariae et al., 2016).”
BackgroundMethodInfluential
Comparative efficacy and acceptability of cognitive behavioral therapy delivery formats for insomnia in adults: A systematic review and network meta-analysis
Gao, Y., Ge, L., Liu, M., Niu, M., Chen, Y., Sun, Y., Chen, J., Yao, L., Wang, Q., Li, Z., et al. (2022) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2022.101648 · Cited by 89 · see citing works
Systematic review and meta-analysis of cognitive-behavioural therapy for insomnia on subjective and actigraphy-measured sleep and comorbid symptoms in cancer survivors
Squires, L. R., Rash, J. A., Fawcett, J., & Garland, S. N. (2022) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2022.101615 · Cited by 85 · see citing works
Internet and In-Person Cognitive Behavioral Therapy for Insomnia in Military Personnel: A Randomized Clinical Trial
Taylor, D. J., Peterson, A. L., Pruiksma, K. E., Young‐McCaughan, S., Nicholson, K. L., & Mintz, J. (2017) · SLEEP · doi:10.1093/sleep/zsx075 · Cited by 87 · see citing works
“The primary hypotheses were that in-person and Internet CBTi would result in greater sleep efficiency improvement from pre-treatment to post-treatment than the control condition and that in-person CBTi would also be superior to Internet CBTi.”
MethodResultInfluential
Trajectories of change and long-term outcomes in a randomised controlled trial of internet-based insomnia treatment to prevent depression
Batterham, P. J., Christensen, H. M., Mackinnon, A. J., Gosling, J. A., Thorndike, F. P., Ritterband, L. M., Glozier, N., & Griffiths, K. M. (2017) · BJPsych Open · doi:10.1192/bjpo.bp.117.005231 · Cited by 85 · see citing works
Acceptance and commitment therapy (ACT) improves sleep quality, experiential avoidance, and emotion regulation in individuals with insomnia-results from a randomized interventional study
Zakiei, A., Khazaie, H., Rostampour, M., Lemola, S., Esmaeili, M., Dürsteler, K., Brühl, A., Sadeghi-Bahmani, D., & Brand, S. (2021) · Life · doi:10.3390/life11020133 · Cited by 84 · see citing works
“CBT-i can be delivered as group-therapy interventions [19,20] or as internet-delivered interventions [21,22].”
Background
Advances in PTSD Treatment Delivery: Review of Findings and Clinical Considerations for the Use of Telehealth Interventions for PTSD
Morland, L. A., Wells, S. Y., Glassman, L. H., Greene, C. J., Hoffman, J. E., & Rosen, C. S. (2020) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-020-00215-x · Cited by 87 · see citing works
A systematic review of cognitive behavioral therapy for insomnia implemented in primary care and community settings
Cheung, J. M. Y., Jarrin, D. C., Ballot, O., Bharwani, A. A., & Morin, C. M. (2018) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2018.11.001 · Cited by 84 · see citing works
Sleep disturbance in psoriasis: a case-controlled study
Jensen, P., Zachariae, C. O. C., Skov, L., & Zachariae, R. H. (2018) · British Journal of Dermatology · doi:10.1111/bjd.16702 · Cited by 87 · see citing works
Digital Interventions for Mental Disorders: Key Features, Efficacy, and Potential for Artificial Intelligence Applications
Ebert, D. D., Harrer, M., Apolinário-Hagen, J., & Baumeister, H. (2019) · Advances in Experimental Medicine and Biology · doi:10.1007/978-981-32-9721-0_29 · Cited by 76 · see citing works
Nurse-Guided Internet-Delivered Cognitive Behavioral Therapy for Insomnia in General Practice: Results from a Pragmatic Randomized Clinical Trial
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Authors: Zachariae, R., Lyby, M. S., Ritterband, L. M., & O'Toole, M. S.
Affiliations: Aarhus University (DK)
University of Virginia (US)
Corresponding author: Zachariae, Robert
ORCID: Zachariae, Robert
Ritterband, Lee M.
Venue: Sleep Medicine Reviews
Publisher: Elsevier BV
Published: 2016-12
Volume: 30
Pages: 1-10
ISSN: 1087-0792 (ISSN-L)
DOI: 10.1016/j.smrv.2015.10.004
OpenAlex: W1863769327
Cited by: 704
References: 82
Citations by year: 2026: 27 · 2025: 81 · 2024: 69 · 2023: 76 · 2022: 78 · 2021: 70 · 2020: 136 · 2019: 47 · 2018: 45 · 2017: 50 · 2016: 22 · 2015: 1 · 2014: 1
FWCI: 5.07
Type: journal article
Language: en
Open access: green
pure.au.dk
Licence: cc-by-nc-nd
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Sleep Medicine Reviews (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
Keywords: internet-based cognitive behavioral therapy, insomnia, treatment efficacy, sleep efficiency, sleep quality, wake after sleep onset, sleep latency, nocturnal awakenings, treatment duration, follow-up maintenance, dropout
MeSH terms: Humans, Sleep Initiation and Maintenance Disorders, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome, Internet

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Efficacy of internet-delivered cognitive-behavioral therapy for insomnia— a systematic review and meta-analysis of randomized controlled trials

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