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Web-based cognitive behavioral therapy for insomnia (CBTi) is the most effective delivery format for improving sleep outcomes in adolescents with insomnia

In a network meta-analysis of 22 RCTs involving adolescents with insomnia, web-based CBTi consistently outperformed other delivery formats (face-to-face, group-based, mobile-app-based, self-help, brief CBTi, and sleep hygiene) across most sleep outcomes. Compared to usual care, web-based CBTi improved total sleep time by 33 minutes, reduced sleep onset latency by 23 minutes, increased sleep efficiency by 7%, and reduced insomnia severity by 5 points.

Last updated: Jul 23, 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 Modalities of Cognitive Behavioral Therapy for Insomnia in Adolescents: A Systematic Review and Network Meta-Analysis.

observational

Rohmah I, Hsieh TN, Jan YW, Hasan F, Chen YC, Widodo AF, Lee HC, Lin CJ, Chiu HY · Worldviews on evidence-based nursing (2026)

Participants: N/A
Duration: N/A
Intervention: Web-based cognitive behavioral therapy for insomnia (CBTi) compared to other delivery formats (face-to-face, group-based, mobile-app-based, self-help, brief CBTi, sleep hygiene) and usual care
Outcome: Total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE), and insomnia severity
Effect Size: TST: +33 min; SOL: -23 min; SE: +7%; insomnia severity: -5 points (vs. usual care)
Population: Adolescents with insomnia (from 22 randomized controlled trials)

Result:

PubMed: 42439579DOI: 10.1111/wvn.70158

Mechanism Graph

Web-based CBTi delivers structured behavioral and cognitive interventions for insomnia
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Interactive online modules provide psychoeducation, stimulus control, sleep restriction, and cognitive restructuring
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Accessibility and convenience may improve adherence and engagement in adolescents
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Result: Superior improvements in sleep continuity and insomnia severity compared to other formats

Limitations

  • ⚠No significant differences were observed for wake after sleep onset (WASO) across modalities
  • ⚠Confidence in evidence and risk of bias were assessed but specific limitations of individual studies may affect generalizability

Frequently Asked Questions

What is web-based CBTi?▼

Web-based CBTi is a digital delivery format of cognitive behavioral therapy for insomnia, typically involving online modules, interactive exercises, and sometimes therapist guidance, designed to improve sleep habits and reduce insomnia symptoms.

How much did web-based CBTi improve sleep in adolescents?▼

Compared to usual care, web-based CBTi increased total sleep time by 33 minutes, reduced sleep onset latency by 23 minutes, improved sleep efficiency by 7%, and decreased insomnia severity by 5 points.

Is web-based CBTi better than face-to-face therapy for adolescent insomnia?▼

According to this network meta-analysis, web-based CBTi outperformed face-to-face, group-based, and other delivery formats across most sleep outcomes in adolescents with insomnia.

What are the limitations of this study?▼

The analysis found no significant differences between modalities for wake after sleep onset (WASO), and the confidence in evidence may be limited by risk of bias in some included studies.

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References

  1. 1.Rohmah I, Hsieh TN, Jan YW, Hasan F, Chen YC, Widodo AF, Lee HC, Lin CJ, Chiu HY. "Comparative Effects of Various Modalities of Cognitive Behavioral Therapy for Insomnia in Adolescents: A Systematic Review and Network Meta-Analysis.." Worldviews on evidence-based nursing, 2026. PMID: 42439579 DOI: 10.1111/wvn.70158
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.