SynthesisSleep & breathing = Schlaf & Atmung2026
Efficacy of fully automated digital cognitive behavioral therapy for insomnia in adults: a systematic review and meta-analysis.
Synthesis in Sleep & breathing = Schlaf & Atmung, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
objectiveFully automated digital cognitive behavioral therapy for insomnia (dCBT-I) is increasingly used as a scalable intervention for adults with insomnia. Although recent reviews have supported its overall efficacy, uncertainty remains regarding the interpretation of platform-related differences across trials. We aimed to evaluate the efficacy of fully automated dCBT-I in adults and to explore whether apparent differences by delivery platform may be related to study-level characteristics.
methodsWe conducted a systematic review and random-effects meta-analysis of randomized controlled trials in general adult populations. Standardized mean differences (SMDs) were pooled using restricted maximum likelihood estimation with truncated Knapp-Hartung adjustment. Subgroup analyses and exploratory meta-regression examined delivery platform and publication year as potential moderators.
resultsFifteen trials (N = 3,507) were included. Fully automated dCBT-I was associated with substantial reductions in insomnia severity (SMD = - 0.82) and consistent improvements in sleep initiation and sleep efficiency, with smaller but significant improvements in sleep quality. In exploratory multivariable meta-regression, the association between delivery platform and treatment effect was attenuated after adjustment for study-level characteristics, including publication year. More recent trials tended to yield smaller effect estimates. Given the limited number of app-based studies, these findings should be interpreted cautiously. Residual heterogeneity was low.
conclusionsFully automated dCBT-I appears to be an effective intervention for adults with insomnia. Platform-related differences were not robust in exploratory analyses and may reflect broader temporal or design-related differences across studies rather than inherent advantages or limitations of a specific delivery format. Further trials, particularly app-based studies, are needed to clarify whether platform-specific effects exist.
Indexed as
Identifiers
42240717What OpenQuestion holds
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.