{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:31:43Z","timestamp":1790638303368,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Co\u2010morbid insomnia and sleep apnoea (COMISA) is a prevalent and debilitating condition. Cognitive behavioural therapy for insomnia (CBTi) is an effective but largely inaccessible treatment in patients with COMISA. We aimed to test a self\u2010guided interactive digital CBTi program tailored for COMISA and insomnia alone. A pilot randomised controlled trial was conducted to investigate the effect of an interactive tailored digital CBTi program, versus digital sleep education (control) on symptoms of insomnia, depression, anxiety, sleepiness, fatigue, and maladaptive beliefs about sleep in people with COMISA. Online questionnaires were administered at baseline, 8\u2009weeks, 16\u2009weeks, and 24\u2009weeks. Intent\u2010to\u2010treat mixed models and complete\u2010case Fisher's exact analyses were used. Participants were 30 adults with COMISA (Age M[sd]\u2009=\u200961.0[10.3], 60% female, BMI\u2009=\u200933.5[6.5]). Compared to control, CBTi was associated with lower insomnia (\n                    <jats:italic>M<\/jats:italic>\n                    [95% CI] difference\u2009=\u20098.3[5.0\u201311.6],\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001,\n                    <jats:italic>d<\/jats:italic>\n                    \u2009=\u20092.88), depression (3.7[1.0\u20136.5],\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.008,\n                    <jats:italic>d<\/jats:italic>\n                    \u2009=\u20091.66), anxiety (2.9[0.9\u20134.9],\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.005,\n                    <jats:italic>d<\/jats:italic>\n                    \u2009=\u20090.62), sleepiness (2.7[0.8\u20134.5],\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.007,\n                    <jats:italic>d<\/jats:italic>\n                    \u2009=\u20090.71), and maladaptive beliefs about sleep (13.9[5.7\u201322.2],\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001,\n                    <jats:italic>d<\/jats:italic>\n                    \u2009=\u20091.16), but not fatigue (1.9[\u22121.2\u20134.9],\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.229,\n                    <jats:italic>d<\/jats:italic>\n                    \u2009=\u20090.68) at 8\u2010week follow\u2010up, controlling for baseline scores. The CBTi group experienced greater rates of insomnia remission (ISI &lt;\u20098; 42%, vs. 0%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.012), and improvement (ISI reduction \u2265\u20096; 75% vs. 14%;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.004) by 8\u2010weeks. Improvements in the CBTi group were sustained by 24\u2010weeks. This tailored digital CBTi program led to large and sustained improvements in insomnia, depression, anxiety, sleepiness, and maladaptive beliefs about sleep in people with COMISA.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    This trial was prospectively registered on the Australian and New Zealand Clinical Trials Registry (ANZCTR, ACTRN12622001218785).\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.anzctr.org.au\/Trial\/Registration\/TrialReview.aspx?id=384648&amp;isReview=true\">https:\/\/www.anzctr.org.au\/Trial\/Registration\/TrialReview.aspx?id=384648&amp;isReview=true<\/jats:ext-link>\n                  <\/jats:p>","DOI":"10.1111\/jsr.70114","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T06:38:24Z","timestamp":1750833504000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Effect of Digital Cognitive Behavioural Therapy for Insomnia in People With Co\u2010Morbid Insomnia and Sleep Apnoea (\n                    <scp>COMISA<\/scp>\n                    ): A Pilot Randomised Controlled Trial"],"prefix":"10.1111","volume":"35","author":[{"given":"Alexander","family":"Sweetman","sequence":"first","affiliation":[{"name":"Adelaide Institute for Sleep Health and Flinders Health and Medical Research Institute: Sleep Health, College of Medicine and Public Health Flinders University  Adelaide Australia"},{"name":"School of Psychological Science University of Western Australia  Perth Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9425-2337","authenticated-orcid":false,"given":"Cele","family":"Richardson","sequence":"additional","affiliation":[{"name":"School of Psychological Science University of Western Australia  Perth Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan","family":"Smith","sequence":"additional","affiliation":[{"name":"Consumer Representative"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5604-6388","authenticated-orcid":false,"given":"Chelsea","family":"Reynolds","sequence":"additional","affiliation":[{"name":"College of Education, Psychology and Social Work Flinders University  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"International Classification of Sleep 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