Digital and AI-Enhanced Cognitive Behavioral Therapy for Insomnia: Neurocognitive Mechanisms and Clinical Outcomes
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Background/Objectives: This systematic review explores the integration of digital and AI-enhanced cognitive behavioral therapy (CBT) for insomnia, focusing on underlying neurocognitive mechanisms and associated clinical outcomes. Insomnia significantly impairs cognitive functioning, overall health, and quality of life. Although traditional CBT has demonstrated efficacy, its scalability and ability to deliver individualized care remain limited. Emerging AI-driven interventions—including chatbots, mobile applications, and web-based platforms—present innovative avenues for delivering more accessible and personalized insomnia treatments. Methods: Following PRISMA guidelines, this review synthesized findings from 78 studies published between 2004 and 2024. A systematic search was conducted across PubMed, Scopus, Web of Science, and PsycINFO. Studies were included based on predefined criteria prioritizing randomized controlled trials (RCTs) and high-quality empirical research that evaluated AI-augmented CBT interventions targeting sleep disorders, particularly insomnia. Results: The findings suggest that digital and AI-enhanced CBT significantly improves sleep parameters, patient adherence, satisfaction, and the personalization of therapy in alignment with individual neurocognitive profiles. Moreover, these technologies address critical limitations of conventional CBT, notably those related to access and scalability. AI-based tools appear especially promising in optimizing treatment delivery and adapting interventions to cognitive-behavioral patterns. Conclusions: While AI-enhanced CBT demonstrates strong potential for advancing insomnia treatment through neurocognitive personalization and broader clinical accessibility, several challenges persist. These include uncertainties surrounding long-term efficacy, practical implementation barriers, and ethical considerations. Future large-scale longitudinal research is necessary to confirm the sustained neurocognitive and behavioral benefits of digital and AI-powered CBT for insomnia.
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Instruction on how to create an optimal sleep environment and the benefits of a regular sleep schedule reinforces positive habits, promoting sleep quality in the long term.
“Instruction on how to create an optimal sleep environment (e.g., dark, quiet, and cool) and the benefits of a regular sleep schedule reinforces these positive habits, promoting sleep quality in the long term [71].”
From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [71]
Section 2.1 identifies sleep hygiene education as a component of CBT for insomnia, and Section 4.7 reports sustained improvements in sleep hygiene and sleep quality after a CBT-I app intervention (pages unavailable). The paper does not specifically say that instruction about a dark, quiet, cool bedroom or a regular sleep schedule reinforces those habits and thereby produces long-term sleep-quality benefits. (LLM, conf=0.84)
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- Authors
- Gkintoni, E., Vassilopoulos, S. P., Nikolaou, G., & Boutsinas, B.
- Affiliations
- University of Patras (GR)
- Department of Educational Sciences and Social Work, University of Patras, 26504 Patras, Greece
- Corresponding author
- Gkintoni, Evgenia
- Venue
- Journal of Clinical Medicine
- Publisher
- MDPI AG
- Published
- 2025-03-26
- Volume
- 14
- Issue
- 7
- Pages
- 2265
- ISSN
- 2077-0383 (ISSN-L)
- PMC
- PMC11989647
- OpenAlex
- W4408943265
- Cited by
- 34
- References
- 171
- Citations by year
- 2026: 16 · 2025: 18
- FWCI
- 5.61
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Clinical Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Research Council of the University of Patras, Greece
- 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
- insomnia, cognitive behavioral therapy, artificial intelligence, chatbots, mobile health apps, digital mental health interventions, neurocognitive mechanisms, personalized treatment, medication adherence, sleep disorders
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