Clinical Report: Investigation of Sleepiness Levels in Insomnia Patients Undergoing dCBT-I

Overview

This study investigates the relationship between daytime sleepiness and treatment outcomes in insomnia patients undergoing digital cognitive behavioral therapy (dCBT-I).

Background

Insomnia is a prevalent sleep disorder that significantly impacts daily functioning and quality of life. Traditional treatments, including pharmacotherapy and cognitive behavioral therapy for insomnia (CBT-I), have limitations, prompting interest in digital CBT-I (dCBT-I) as an effective alternative. Understanding factors influencing treatment outcomes, such as daytime sleepiness, is crucial for optimizing insomnia management.

Data Highlights

Key Findings

• Daytime sleepiness, measured by the Epworth Sleepiness Scale (ESS), peaked at week 2 of dCBT-I treatment.
• Factors influencing daytime sleepiness included sex, medication use, snoring, and baseline ESS scores.
• Patients with increased sleepiness at week 2 showed greater reductions in Pittsburgh Sleep Quality Index (PSQI) scores at subsequent follow-ups.
• Univariate and multivariable regression analyses indicated that early increased sleepiness independently predicted higher PSQI reductions at weeks 4, 8, 12, and 16.
• Transient daytime sleepiness is common in the early stages of dCBT-I.

Clinical Implications

Clinicians should monitor daytime sleepiness in patients undergoing dCBT-I, as it may indicate treatment response. Understanding the factors contributing to sleepiness can help tailor interventions and improve adherence to therapy.

Conclusion

Increased daytime sleepiness during early dCBT-I may be a transient phenomenon that predicts better treatment outcomes, highlighting the need for careful assessment and management in insomnia patients.

Related Resources & Content

1. Frontiers in Psychiatry, 2026 -- Cognitive-attitudinal factors predict CBT-I enrollment willingness in Chinese sleep clinic patients
2. conexiant -- Insomnia Outcomes May Vary by Measurement Method
3. BMC Psychiatry (Springer) -- Objectively measured cognitive function in insomnia patients with and without comorbid depression treated with cognitive behavioral therapy for insomnia
4. BMC Psychiatry (Springer) -- Digital multi-modal approaches to subtyping insomnia disorder (DIMOSI)
5. VA/DoD Clinical Practice Guideline, 2025 -- Insomnia
6. Journal of Medical Internet Research -- Validating the Efficacy of a Mobile Digital Therapeutic for Insomnia (WELT-I)
7. SLEEP | Oxford Academic -- Sleep Restriction Therapy for Insomnia
8. https://www.healthquality.va.gov/guidelines/CD/insomnia/I-OSA-CPG_2025-Guideline_final_20250915.pdf
9. Journal of Medical Internet Research - Validating the Efficacy of a Mobile Digital Therapeutic for Insomnia (WELT-I): Randomized Controlled Decentralized Clinical Trial
10. Sleep Restriction Therapy for Insomnia is Associated with Reduced Objective Total Sleep Time, Increased Daytime Somnolence, and Objectively Impaired Vigilance: Implications for the Clinical Management of Insomnia Disorder | SLEEP | Oxford Academic