{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:17:09Z","timestamp":1788153429669,"version":"build-2803163510"},"reference-count":50,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC 114\u20102314\u2010B\u2010038\u2010094\u2010MY3"],"award-info":[{"award-number":["NSTC 114\u20102314\u2010B\u2010038\u2010094\u2010MY3"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC 113\u20102628\u2010B\u2010038\u2010003\u2010MY3"],"award-info":[{"award-number":["NSTC 113\u20102628\u2010B\u2010038\u2010003\u2010MY3"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["sigmapubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Worldviews Ev Based Nurs"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Insomnia during adolescence impairs mood and cognitive functioning, yet access to effective behavioral sleep treatment is limited. Although CBTi is considered the first\u2010line therapy, the relative value of different delivery formats has remained unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study systematically evaluated and compared the efficacy of various cognitive behavioral therapy for insomnia (CBTi) delivery formats in improving sleep outcomes among adolescents using a network meta\u2010analysis (NMA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive search of five databases, namely PubMed, Embase, PsycINFO, CINAHL, and the Cochrane Library, was conducted through September 28, 2025. Eligible studies were randomized controlled trials (RCTs) involving adolescents with insomnia that examined at least one CBTi modality, including web\u2010based, face\u2010to\u2010face, group\u2010based, mobile\u2010app\u2010based, self\u2010help, brief CBTi, and sleep hygiene. Both pairwise and network meta\u2010analyses were conducted using a frequentist random\u2010effects model. Risk of bias was evaluated using the Cochrane Risk of Bias 2.0 tool, and confidence in evidence was examined using the Confidence in NMA framework. Sleep outcomes included total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE), and insomnia severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010two RCTs evaluating seven CBTi modalities were analyzed. Web\u2010based CBTi consistently outperformed other delivery formats across most outcomes, significantly improving TST by 33\u2009min, reducing SOL by 23\u2009min, increasing SE by 7%, and reducing insomnia severity by 5 points compared with usual care. P score analysis identified web\u2010based CBTi as the most effective modality for TST (86%), SOL (79%), SE (74%), and insomnia severity (99%). No significant differences were observed for WASO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Linking Evidence to Action<\/jats:title>\n                    <jats:p>Web\u2010based CBTi is the most effective delivery format for improving sleep outcomes among adolescents. These findings support integrating CBTi into adolescent\u2010focused sleep care pathways. Implementation of web\u2010based CBTi as a first\u2010line option in school and primary\u2010care pathways could expand access and improve outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO: CRD420251128688<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/wvn.70158","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T13:06:39Z","timestamp":1783947999000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Effects of Various Modalities of Cognitive Behavioral Therapy for Insomnia in Adolescents: A Systematic Review and Network Meta\u2010Analysis"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7562-4721","authenticated-orcid":false,"given":"Iftitakhur","family":"Rohmah","sequence":"first","affiliation":[{"name":"Faculty of Nursing Chulalongkorn University  Bangkok Thailand"},{"name":"School of Nursing, College of Nursing Taipei Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ti\u2010No","family":"Hsieh","sequence":"additional","affiliation":[{"name":"School of Nursing, College of Nursing Taipei Medical University  Taipei Taiwan"},{"name":"Department of Nursing National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya\u2010Wen","family":"Jan","sequence":"additional","affiliation":[{"name":"Department of Psychology Chung Yuan Christian University  Taoyuan Taiwan"},{"name":"Department of Clinical Psychology Fu\u2010Jen Catholic University  Taipei 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