A randomized controlled trial of a digital cognitive behavioral therapy for insomnia for older adults

A randomized controlled trial of a digital cognitive behavioral therapy for insomnia for older adults

Abstract Older adults with insomnia face considerable challenges accessing treatment given limited availability to first-line therapy (Cognitive-Behavioral Therapy for Insomnia, CBT-I). This study evaluated the efficacy of Sleep Healthy Using the Internet for Older Adults Suffering with Insomnia and...

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Main Authors: Lee M. Ritterband, Kelly M. Shaffer, Frances P. Thorndike, Philip I. Chow, Linda Gonder-Frederick, Karen S. Ingersoll, Wendy F. Cohn, Christina Frederick, Kirsten MacDonnell, Jillian V. Glazer, Meghan K. Mattos, Michelle M. Hilgart, Mark S. Quigg, Mudhasir Bashir, Charles M. Morin
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:npj Digital Medicine
Online Access:https://doi.org/10.1038/s41746-025-01847-0
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Summary:Abstract Older adults with insomnia face considerable challenges accessing treatment given limited availability to first-line therapy (Cognitive-Behavioral Therapy for Insomnia, CBT-I). This study evaluated the efficacy of Sleep Healthy Using the Internet for Older Adults Suffering with Insomnia and Sleeplessness (SHUTi OASIS), a tailored CBT-I internet intervention for older adults with insomnia, in a 3-arm randomized controlled trial (SHUTi OASIS alone, SHUTi OASIS + stepped support, online patient education [PE]). 311 participants (ages 55–95) were randomized to receive SHUTi OASIS (alone n = 105; with stepped support n = 102), with both conditions reporting significant improvements across post, 6-month, and 12-month follow-ups in insomnia severity compared to those receiving PE (n = 104). Clinically meaningful indices of insomnia response and remission were also higher among those receiving SHUTi OASIS. Those who received SHUTi OASIS also significantly outperformed those receiving PE on secondary outcomes, including sleep onset latency, wake after sleep onset, sleep efficiency, number of awakenings, sleep quality, and fatigue, across most timepoints. Results indicate that digital CBT-I provides important benefits for older adults, offering strong potential to expand access to insomnia treatment for this underserved population.
ISSN:2398-6352

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