Supplements

Digital CBTi shows the largest reduction in insomnia severity among cancer survivors compared to other delivery methods

In a network meta-analysis of 22 RCTs involving 2040 cancer patients, digital CBTi (dCBTi) demonstrated the largest reduction in insomnia severity index (ISI) scores compared to treatment as usual (MD = -9.70, 95% CI = -10.80 to -8.61), followed by telephone CBTi (MD = -8.74). dCBTi also significantly improved sleep onset latency (-30.95 min), wake after sleep onset (-25.62 min), total sleep time (+31.67 min), and sleep efficiency (+14.63%). However, the certainty of evidence was low to very low due to imprecision and network incoherence.

Last updated: Sep 2, 2026•0 RCTs•1 Meta-analyses•📖 Read as article →

Evidence Score

Evidence Score49/100
Human RCT☆☆☆☆☆
Meta-analysis★★★☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Comparative Effects of Various Delivery Methods of Cognitive Behavioral Therapy for Insomnia Among Patients With Cancers: Systematic Review and Network Meta-Analysis.

observational

Lee CI, Mukminin MA, Jan YW, Wang TH, Huang TW, Chiu HY · Psycho-oncology (2026)

Participants: N/A
Duration: Not specified (varies by included trials)
Intervention: Digital cognitive behavioral therapy for insomnia (dCBTi) compared to other delivery modes (telephone, group, face-to-face) and treatment as usual
Outcome: Insomnia Severity Index (ISI), sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), sleep efficiency (SE)
Effect Size: MD = -9.70 (95% CI: -10.80 to -8.61) for ISI; other outcomes: SOL MD = -30.95 min, WASO MD = -25.62 min, TST MD = +31.67 min, SE MD = +14.63%
Population: Adult cancer survivors with insomnia (mean age not specified, but includes various cancer types, with breast cancer as a moderator)

Result:

PubMed: 42670890DOI: 10.1002/pon.70593

Mechanism Graph

CBTi targets maladaptive sleep behaviors and cognitive arousal
↓
Digital delivery increases accessibility and adherence
↓
Improved sleep onset and maintenance
↓
Reduced insomnia severity

Limitations

  • ⚠Low to very low certainty of evidence due to imprecision and network incoherence
  • ⚠Meta-regression identified breast cancer as a moderator, but other cancer types may respond differently
  • ⚠No head-to-head trials directly comparing delivery modes

Frequently Asked Questions

What is the most effective delivery method for CBTi in cancer survivors?▼

According to this network meta-analysis, digital CBTi (dCBTi) showed the largest improvement in insomnia severity and sleep parameters compared to other delivery methods, but evidence certainty is low.

How much does digital CBTi reduce insomnia severity in cancer patients?▼

Digital CBTi reduced the Insomnia Severity Index by an average of 9.70 points compared to treatment as usual, which is a clinically significant improvement.

Does digital CBTi improve sleep efficiency in cancer survivors?▼

Yes, digital CBTi improved sleep efficiency by 14.63% on average, along with reducing sleep onset latency and wake after sleep onset.

Are there any moderators of digital CBTi effectiveness?▼

Breast cancer diagnosis was found to moderate the effects on sleep onset latency and sleep efficiency, suggesting that cancer type may influence outcomes.

Products

Affiliate links coming soon. We only recommend products that match the doses and forms used in the cited research.

References

  1. 1.Lee CI, Mukminin MA, Jan YW, Wang TH, Huang TW, Chiu HY. "Comparative Effects of Various Delivery Methods of Cognitive Behavioral Therapy for Insomnia Among Patients With Cancers: Systematic Review and Network Meta-Analysis.." Psycho-oncology, 2026. PMID: 42670890 DOI: 10.1002/pon.70593
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.