{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T19:20:20Z","timestamp":1793992820125,"version":"4.8.0"},"reference-count":77,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:00:00Z","timestamp":1688947200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Mementor DE GmbH"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Study Objectives<\/jats:title>\n                  <jats:p>Numerous studies worldwide have reported the beneficial effects of digital cognitive behavioral therapy for insomnia (dCBT-I). However, few focus on real-world study samples that reflect people in regular care. To test whether dCBT-I is suitable within German regular care, we designed a randomized controlled trial recruiting a heterogenous insomnia population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Participants aged \u226518 who met the criteria for insomnia disorder were randomized to 8-weeks dCBT-I\u2005+\u2005care-as-usual (CAU) or they were set on a waitlist\u2005+\u2005CAU. The intervention group was followed-up at 6- and 12-months. The primary outcome was self-reported insomnia severity, assessed with the Insomnia Severity Index (ISI) at 8-weeks post-randomization. A one-way ANCOVA with baseline score as a covariate was fitted to determine group differences. Secondary outcomes included measures of daytime functioning, quality of life, depression, anxiety, dreams, and nightmares.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the N\u2005=\u2005238 participants (67.6% female), age range 19\u201381 years, n\u2005=\u2005118 were randomized to dCBT-I and n\u2005=\u2005120 to the control group. At posttreatment, the use of dCBT-I was associated with a large reduction in the ISI (Diffadj\u2005=\u2005\u20137.60) in comparison to WLC (d\u2005=\u2005\u20132.08). This clinical improvement was also reflected in responder and remission rates. Treatment effects were also observed for daytime functioning, quality of life, symptoms of depression and anxiety (ds\u2005=\u20050.26\u20131.02) and at long-term follow-up (intervention group only; ds\u2005=\u20050.18\u20131.65). No effects were found for dream and nightmare frequency.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study showed that dCBT-I reduces insomnia symptoms and improves daytime functioning in a heterogenous insomnia population in Germany with sustained long-term treatment effects in the intervention group. Our results underscore the potential of digital health applications, their suitability within regular care, and their role in facilitating widespread implementation of CBT-I as a first-line treatment for insomnia.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/sleep\/zsad184","type":"journal-article","created":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T00:09:38Z","timestamp":1689034178000},"source":"Crossref","is-referenced-by-count":44,"title":["The clinical effects of digital cognitive behavioral therapy for insomnia in a heterogenous study sample: results from a randomized controlled trial"],"prefix":"10.1093","volume":"46","author":[{"given":"Jennifer","family":"Schuffelen","sequence":"first","affiliation":[{"name":"Heinrich Heine University D\u00fcsseldorf, Institute of Experimental Psychology, Department of Clinical Psychology , Germany 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