Innovative Digital Cognitive Behavioral Treatment for Insomnia Disorder in Adults (dCBT-i): Framework Development

Abstract

Background: Chronic insomnia, or insomnia disorder, is a major health issue with a prevalence of up to 15%. The recommended first-line treatment is cognitive behavioral therapy for insomnia (CBT-i), which, unfortunately, remains insufficiently accessible. Digitalization has the potential to reduce health care access inequalities by offering more flexible and accessible care options. Digital CBT-i (dCBT-i) has been shown to be as effective as in-person CBT-i, highlighting its potential for broader implementation.

Objective: This study aimed to develop an evidence-based dCBT-i program grounded in theoretical and clinical knowledge, designed for efficient integration into health care systems, and to establish it as the first prescribed digital treatment in France.

Methods: The program was constructed based on validated CBT-i theory and practice, incorporating the latest scientific data on CBT for insomnia. It was designed as a robust multicomponent therapy, integrating an initial standardized assessment and daily intelligent adaptation to enable digital phenotyping and provide personalized treatment.

Results: We developed an innovative digital solution that combines scientific rigor with practical application. The program includes a standardized initial evaluation and dynamic personalization through intelligent algorithms. These features allow for the adaptation of therapy based on patient progress and needs, ensuring individualized care.

Conclusions: The development of this dCBT-i program represents a significant milestone in digital health care, offering a scalable solution to the accessibility challenges of traditional CBT-i. Future steps involve conducting clinical studies to further evaluate its effectiveness and optimize its implementation within health care systems.

Keywords: CBT-i; digital program; insomnia; integrative therapies; nonpharmacological intervention.