Randomized Controlled Trial
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Apr 19, 2025; 15(4): 104042
Published online Apr 19, 2025. doi: 10.5498/wjp.v15.i4.104042
Digital cognitive behavioral therapy as a novel treatment for insomnia
Xu-Tong Tian, Yao Meng, Ru-Lan Wang, Rong Tan, Mei-Shan Liu, Wen Xu, Shuai Cui, Yun-Xiang Tang, Meng-Yang He, Wen-Peng Cai
Xu-Tong Tian, Ru-Lan Wang, Rong Tan, Mei-Shan Liu, Wen Xu, Shuai Cui, School of Basic Medicine, Naval Medical University, Shanghai 200433, China
Yao Meng, Naval Medical Center, Naval Medical University, Shanghai 200433, China
Yun-Xiang Tang, Wen-Peng Cai, Faculty of Psychology, Naval Medical University, Shanghai 200433, China
Meng-Yang He, Department of Psychology, School of Sports Medicine, Wuhan Sports University, Wuhan 430000, Hubei Province, China
Co-first authors: Xu-Tong Tian and Yao Meng.
Co-corresponding authors: Meng-Yang He and Wen-Peng Cai.
Author contributions: Tang YX, He MY, and Cai WP collaborated in designing the general concept and structure of the manuscript; Tian XT, Meng Y, and Wang RL wrote and edited the manuscript, reviewed the literature, and designed the illustrations; Tan R, Liu MS, Xu W and Cui S contributed to finalizing the manuscript text.
Supported by the Shanghai Pujiang Program, No. 2020PJC115; Social Science Incubation Fund of Naval Medical University, No. 2022SK027; Scientific Research Program of Provincial Department of Education, No. Q20224105; Research on the High-quality Development of Sports Talents in Hubei Province’s Universities Under the Background of Integration of Sports and Education, No. 2022GA059.
Institutional review board statement: This study was reviewed and approved by the Ethics Review Committee of Wuhan Sports University (No. 2024069).
Clinical trial registration statement: Our clinical trial study dates are from April to June 2023. Our experiment has been successfully registered with OSF. Supplementary material associated with this article can be found, in the online version, at https://doi.org/10.17605/OSF.IO/59T4A. Trial registration date: March 12, 2024, so, our trial registration was retrospectively registered.
Informed consent statement: We hereby state that we obtained written informed consent from the participants and that they have consented to the release of all images, clinical data, and all other data.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen-Peng Cai, MD, PhD, Associate Professor, Faculty of Psychology, Naval Medical University, No. 800 Xiangyin Road, Shanghai 200433, China. wpcai@smmu.edu.cn
Received: December 29, 2024
Revised: February 6, 2025
Accepted: February 24, 2025
Published online: April 19, 2025
Processing time: 86 Days and 20.4 Hours
Abstract
BACKGROUND

As a substitute for traditional drug therapy, digital cognitive-behavioral therapy positively impacts the regulation of brain function, which can improve insomnia. However, there is currently a paucity of studies on digital cognitive behavioral therapy as a treatment for insomnia.

AIM

To assess digital cognitive behavioral therapy for insomnia regarding its positive impact on brain function.

METHODS

Participants were randomly assigned to either a go/no-go group or a dot-probe group. The primary outcome was quality of sleep as assessed by the actigraphy sleep monitoring bracelet, Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI), and depression anxiety and stress scale (DASS-21).

RESULTS

Eighty patients were included in the analysis (go/no-go group: n = 40; dot-probe group: n = 40). We combined the total scale scores of the two groups before and after the intervention in the analysis of covariance. Our study explored whether insomnia symptoms in both groups can be improved by using digital cognitive behavioral therapy instead of trying to compare the two trials; therefore, only one P value is listed. In both groups, we found a short-term time effect on insomnia symptom severity (PSQI: P < 0.001, η2 = 0.336; ISI: P < 0.001, η2 = 0.667; DASS-depression: P < 0.001, η2 = 0.582; DASS-anxiety: P < 0.001, η2 = 0.337; DASS-stress: P < 0.001, η2 = 0.443) and some effect on sleep efficiency (but it was not significant, P = 0.585, η2 = 0.004).

CONCLUSION

Go/no-go task training of inhibitory function had a short-term positive effect on sleep efficiency, whereas dot-probe task training had a positive short-term effect on emotion regulation.

Keywords: Digital cognitive behavioral therapy; Insomnia; Sleep efficiency; Go/no-go task; Dot-probe task

Core Tip: In recent years, few studies have explored the use of digital cognitive behavioral therapy for treatment of insomnia. This paper offers a detailed summary and discussion of the results and mechanisms of the improved sleep efficiency observed after a digital cognitive behavioral therapy intervention. We found that go/no-go and dot-probe tasks exhibited large anti-insomnia effects. Go/no-go task training of inhibitory function had a short-term positive effect on sleep efficiency.