A systematic review and network meta-analysis of 22 randomised trials comparing seven CBT-I formats found web-based CBT-I leading several outcomes versus usual care: 33 more minutes of total sleep, 23 fewer minutes to sleep onset, 7% higher sleep efficiency and five points lower insomnia severity. Wake after sleep onset did not differ significantly. Rankings depend on network assumptions and trial quality and do not prescribe one format for every adolescent.
Key findings
- Across 22 RCTs, web CBT-I versus usual care improved TST by 33 minutes, reduced SOL by 23 minutes, increased SE by 7% and reduced insomnia severity by five points. P scores ranked web delivery highest for TST (86%), SOL (79%), SE (74%) and severity (99%); WASO showed no significant difference.
Why this matters globally
The results support piloting digital CBT-I in schools and primary care to address access gaps, with screening for suicide risk, bipolar disorder and sleep-disordered breathing plus human referral pathways.
Thai researcher contribution
Iftitakhur Rohmah and Faizul Hasan are affiliated with Chulalongkorn University's Faculty of Nursing and Taipei Medical University, contributing Thai-linked expertise to international sleep evidence synthesis.
Limitations to consider
NMA depends on transitivity and consistency across heterogeneous ages, programmes, durations, comparators and measures. P scores alone do not capture effect magnitude or certainty, and the abstract does not show heterogeneity, inconsistency or outcome-specific confidence.
Verify the original sources
Worldviews on Evidence-Based NursingRead the original article↗DOI: 10.1111/wvn.70158