Trial reportSleep2023
Co-occurring insomnia and anxiety: a randomized controlled trial of internet cognitive behavioral therapy for insomnia versus internet cognitive behavioral therapy for anxiety.
Trial report in Sleep, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- The intervention effect of internet-based cognitive behavioral therapy on anxiety, depression, and stress in college students: a systematic review and meta-analysis based on randomized controlled trials.Frontiers in psychology · 2026Pooled it
- Pooled it
- Trial
- Predictors of depression outcomes among university students following brief smartphone-based interventions.Npj mental health research · 2026Article
- Article
- The interrelationships among insomnia, frailty, anxiety, and cognitive function in middle-aged and older adults: a cross-sectional study.Frontiers in psychiatry · 2026Article
- Management of adult insomnia in Australia: a joint position statement of the Australasian Sleep Association, Sleep Health Foundation, Royal Australian College of General Practitioners, Australian Psychological Society, Pharmaceutical Society of Australia, and Australian Primary Health Care Nurses Association.Sleep advances : a journal of the Sleep Research Society · 2026Review
- Direct to psychology stepped care model implementation in the multidisciplinary sleep service: study protocol.BMC health services research · 2025Article
- Applying therapist-guided digital cognitive behavioral therapy for insomnia in psychiatry: a mixed-methods process evaluation.BMC psychiatry · 2025Article
- Systematic review and meta-analysis on fully automated digital cognitive behavioral therapy for insomnia.NPJ digital medicine · 2025Article
- Inflammatory state moderates response to cannabis on negative affect and sleep quality in individuals with anxiety.Frontiers in behavioral neuroscience · 2025Article
- Expressive suppression mediates the relationship between sleep quality and generalized anxiety symptomology.Scientific reports · 2024Article
- From trenches to technology: a narrative review of sleep medicine in the military.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Review
- The sleep-circadian interface: A window into mental disorders.Proceedings of the National Academy of Sciences of the United States of America · 2024Review
- Protocol for a randomised controlled trial evaluating the effect of a CBT-I smartphone application (Sleep Ninja®) on insomnia symptoms in children.BMC psychiatry · 2023Article
- The Relationship between Anxiety, Subjective and Objective Sleep, Chronotype and Circadian Rhythms with Depressive Symptoms in Insomnia Disorder.Brain sciences · 2023Article
- Article
- Predictors of health-related quality of life in outpatients with coronary heart disease.Frontiers in psychology · 2023Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesInsomnia and anxiety are highly prevalent and frequently co-occur. Given limited therapeutic resources and time constraints, the aim of this study was to compare which treatment-internet cognitive behavioral therapy (CBT) for insomnia or internet CBT for anxiety-leads to the best outcomes in individuals with comorbid insomnia and anxiety.
methods120 participants with comorbid insomnia and clinical anxiety (as defined by scores above the clinical cutoff on the insomnia severity index (ISI) and the generalized anxiety disorder 7-item scale (GAD-7)) were randomized to receive internet-based cognitive behavioral therapy (iCBT) for insomnia or iCBT for anxiety. The primary outcome measures were the ISI and the generalized anxiety disorder 7-item scale. Primary outcome measures were assessed before treatment, at mid-treatment, at post-treatment, and 3 months after treatment. Secondary outcome measures assessed depression symptoms, distress, and sleep diary parameters.
resultsParticipants in both groups experienced large reductions in symptoms of insomnia, anxiety, depression, and distress, as well as improvements in sleep efficiency and total sleep time. Improvements were maintained at follow-up. Crucially, at the end of treatment, the insomnia treatment was more effective in reducing symptoms of insomnia than the anxiety treatment, and equally effective in reducing symptoms of anxiety. Treatment gains were maintained at 3-month follow-up, however, there were no differences between groups at that time point.
conclusionsThese results suggest that in the common case of a patient presenting with comorbid insomnia and anxiety, treatment for insomnia may be the most efficient treatment strategy.
trial registrationThe trial was registered with the Australian and New Zealand Clinical Trials Registry, https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618001141235. Trial ID: ACTRN12618001141235. Trial name: a comparison of internet-based CBT for insomnia versus internet-based CBT for anxiety in a comorbid sample.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.