Comparative efficacy of different digital technologies in adults with insomnia: a systematic review and network meta-analysis of randomized controlled trials
5 affiliations
- 1School of Nursing, Shanxi University of Chinese Medicine
- 2Department of Neonatology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital
- 3School of Basic Medical Sciences, Shanxi University of Chinese Medicine
- 4Department of Gastroenterology, Shanxi Hospital of Integrated Traditional Chinese and Western Medicine
- 5The First Clinical Medical College, Shanxi University of Chinese Medicine
Abstract
Objective: To evaluate the efficacy of eight digital interventions for adults with insomnia and compare their relative effects using Bayesian network meta-analysis, so as to provide evidence-based references for digital insomnia management.
Methods: Randomized controlled trials (RCTs) were retrieved from six electronic databases up to February 7, 2026. Eligible studies enrolled adult participants with insomnia, with primary outcomes including the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Sleep Onset Latency (SOL), and Wake After Sleep Onset (WASO). Risk of bias was assessed using the RoB 2.0 tool. Intervention hierarchies were obtained using the surface under the cumulative ranking curve (SUCRA). The GRADE framework for network meta-analysis was applied to rate evidence certainty.
Results: Twenty-six RCTs involving 6 353 participants covering eight digital interventions were included. Conventional meta-analysis showed that digital interventions significantly reduced ISI (MD = 3.31, 95%CI 2.48-4.15, P < 0.001, I² = 67%), improved PSQI (MD = 1.52, 95%CI 1.07-1.97, P < 0.001, I² = 0%), and shortened SOL (MD = 12.60, 95%CI 7.66-17.55, P < 0.001, I² = 0%) and WASO (MD = 16.93, 95%CI 8.90-24.96, P < 0.001, I² = 0%). Network meta-analysis suggested that combined digital cognitive behavioral therapy for insomnia with wearable devices (DCBT-I+WD) and biofeedback (BF) obtained favourable SUCRA ranks for ISI reduction; BF and digital cognitive behavioral therapy for insomnia (DCBT-I) ranked highly for PSQI improvement; DCBT-I had the highest SUCRA for SOL reduction; DCBT-I and digital sleep education (DSE) showed relatively good performance for WASO reduction.
Conclusion: Different digital technologies can significantly improve various sleep outcomes among adults with insomnia. DCBT-I showed favourable effect estimates. However, data on some digital interventions in some outcomes were mainly based on limited primary studies with sparse direct comparative evidence and thus were highly uncertain and do not allow firm conclusions. Large-sample, multicentre, longitudinal RCTs remain necessary to verify their long-term therapeutic effects.
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BibTeX
@article{wang2026comparative,
title = {{Comparative efficacy of different digital technologies in adults with insomnia: a systematic review and network meta-analysis of randomized controlled trials}},
author = {Xinyu Wang and Yong Zhao and Li Wang and Caifeng Du and Ke Ding and Qianqian Wen and Wenjing Liang and Taoyi He},
journal = {Frontiers in Psychiatry},
year = {2026},
month = nov,
doi = {10.3389/fpsyt.2026.1929377},
url = {https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1929377/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Comparative efficacy of different digital technologies in adults with insomnia: a systematic review and network meta-analysis of randomized controlled trials
AU - Xinyu Wang
AU - Yong Zhao
AU - Li Wang
AU - Caifeng Du
AU - Ke Ding
AU - Qianqian Wen
AU - Wenjing Liang
AU - Taoyi He
PY - 2026
DA - 2026/11/06
JO - Frontiers in Psychiatry
DO - 10.3389/fpsyt.2026.1929377
UR - https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1929377/full
AB - Objective: To evaluate the efficacy of eight digital interventions for adults with insomnia and compare their relative effects using Bayesian network meta-analysis, so as to provide evidence-based references for digital insomnia management. Methods: Randomized controlled trials (RCTs) were retrieved from six electronic databases up to February 7, 2026. Eligible studies enrolled adult participants with insomnia, with primary outcomes including the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Sleep Onset Latency (SOL), and Wake After Sleep Onset (WASO). Risk of bias was assessed using the RoB 2.0 tool. Intervention hierarchies were obtained using the surface under the cumulative ranking curve (SUCRA). The GRADE framework for network meta-analysis was applied to rate evidence certainty. Results: Twenty-six RCTs involving 6 353 participants covering eight digital interventions were included. Conventional meta-analysis showed that digital interventions significantly reduced ISI (MD = 3.31, 95%CI 2.48-4.15, P < 0.001, I² = 67%), improved PSQI (MD = 1.52, 95%CI 1.07-1.97, P < 0.001, I² = 0%), and shortened SOL (MD = 12.60, 95%CI 7.66-17.55, P < 0.001, I² = 0%) and WASO (MD = 16.93, 95%CI 8.90-24.96, P < 0.001, I² = 0%). Network meta-analysis suggested that combined digital cognitive behavioral therapy for insomnia with wearable devices (DCBT-I+WD) and biofeedback (BF) obtained favourable SUCRA ranks for ISI reduction; BF and digital cognitive behavioral therapy for insomnia (DCBT-I) ranked highly for PSQI improvement; DCBT-I had the highest SUCRA for SOL reduction; DCBT-I and digital sleep education (DSE) showed relatively good performance for WASO reduction. Conclusion: Different digital technologies can significantly improve various sleep outcomes among adults with insomnia. DCBT-I showed favourable effect estimates. However, data on some digital interventions in some outcomes were mainly based on limited primary studies with sparse direct comparative evidence and thus were highly uncertain and do not allow firm conclusions. Large-sample, multicentre, longitudinal RCTs remain necessary to verify their long-term therapeutic effects.
SN - 1664-0640
ER -