Digital Health Strategies for Adolescent Sleep: Systematic Review and Meta-Analysis

Overview

This systematic review and meta-analysis of 18 randomized controlled trials involving 13,296 adolescents evaluated digital health interventions (DHIs) for sleep improvement. Digital cognitive behavioral therapy for insomnia (dCBT-I) significantly reduced insomnia severity and modestly improved sleep quality, with additional mental health benefits, while educational and lifestyle interventions showed mixed results.

Background

Adolescence, spanning ages 10 to 24, is a critical developmental period marked by neurobiological, hormonal, and psychosocial changes that impact sleep patterns. Despite recommendations for adequate sleep duration, many adolescents fail to meet these guidelines, with insomnia being the most prevalent sleep disturbance. Poor sleep in this population is linked to adverse cognitive, emotional, and physical health outcomes, including increased risk for mental health disorders. Cognitive Behavioral Therapy for Insomnia (CBT-I) is an evidence-based treatment that targets behavioral and cognitive factors contributing to sleep problems and can be delivered digitally to enhance accessibility.

Data Highlights

Key Findings

• Digital cognitive behavioral therapy for insomnia (dCBT-I) significantly reduces insomnia severity in adolescents (SMD = -3.32).
• dCBT-I modestly improves overall sleep quality (SMD = -0.32) and provides secondary mental health benefits.
• Educational and lifestyle digital interventions targeting sleep promotion yield inconsistent or mixed effects.
• Most DHIs were unguided or minimally supported online, highlighting scalability potential.
• Active components identified include cognitive restructuring, mindfulness, stimulus control, and sleep restriction.
• dCBT-I is particularly effective for adolescents experiencing insomnia or poor sleep.

Clinical Implications

Clinicians should consider digital cognitive behavioral therapy as a first-line scalable intervention for adolescents with insomnia or poor sleep, given its demonstrated efficacy and mental health benefits. Incorporating active components such as cognitive restructuring and stimulus control can enhance treatment outcomes. Future clinical practice should also focus on refining digital delivery methods and ensuring intervention fidelity to sustain improvements.

Conclusion

Digital cognitive behavioral therapy for insomnia is an effective and accessible approach to improving adolescent sleep and associated mental health outcomes. Continued research is needed to optimize digital intervention components and delivery for sustained benefits.

References

1. Key Elements of Digital Health Strategies for Adolescent Sleep: A Systematic Review and Meta-Analysis of Randomized Controlled Trials