Baseer Maroof, LCSW · Raleigh, NC · Adults 21+
Digital CBT-I
Apps can deliver real CBT-I. Most sleep apps don’t. Here’s how to tell the difference.
In short
- Digital CBT-I is a legitimate option. The European guideline lists it as first-line alongside in-person care.
- Look for programs with published randomized trials, not a sleep tracker or a meditation app.
- Free options exist: the VA’s Insomnia Coach for anyone, and CBT-i Coach as a companion to therapy.
- If it stalls, or other health or mental health conditions are in the mix, work with a clinician.
Options with real evidence
| Program | What it is | Access |
|---|---|---|
| SleepioRx | Digital CBT-I, FDA-cleared (510(k), Aug 2024), adults 18+ | Prescription |
| Somryst | 9-week digital CBT-I, adults 22+ | Prescription; maker says availability is currently limited |
| Insomnia Coach (VA) | Free self-guided 5-week program | Free app, anyone |
| CBT-i Coach (VA) | Companion for people in CBT-I with a clinician | Free app |
| SHUTi | 6-week web program from UVA, tested in trials | Through research studies |
Big Health; NICE MTG70; Somryst; VA; UVA. Checked October 2026.
The evidence
Sleepio trial
1,711 people randomized to digital CBT-I or sleep hygiene education. The CBT-I group improved more in daytime function, well-being and sleep-related quality of life. Disclosure: lead author Colin Espie co-founded Big Health, which makes Sleepio. (Espie 2019)
SHUTi trial
303 adults; the web program beat online patient education on insomnia severity, time to fall asleep and time awake at night. At 1 year, 56.6% of SHUTi users assessed were in remission and 69.7% were treatment responders. (Ritterband 2017)
Health system view
NICE (UK) recommends Sleepio in primary care for people who would otherwise be offered sleep hygiene advice or sleeping pills. It asks for a medical assessment first for people at higher risk of other sleep disorders, such as people with other conditions. (NICE MTG70)
Choosing one
A quick filter
- Does it include a sleep diary and a sleep window (sleep restriction)? If not, it isn’t really CBT-I.
- Is there a published randomized trial of the program itself?
- Does it screen for things that need a medical look first, like sleep apnea or seizures?
The VA’s CBT-i Coach is a solid free companion if you’re working with me or another CBT-I clinician.
Sources
All sources, linked9 references⌄
- Riemann D, et al. (2023). The European Insomnia Guideline: an update on the diagnosis and treatment of insomnia 2023. J Sleep Res 32(6):e14035. doi.org/10.1111/jsr.14035
- Big Health (August 2024). U.S. FDA grants clearance for SleepioRx. www.bighealth.com/news/us-fda-grants-clearance-for-sleepiorx
- NICE (2022). Sleepio to treat insomnia and insomnia symptoms. Medical technologies guidance MTG70 (now HealthTech guidance HTG624). www.nice.org.uk/guidance/mtg70
- Somryst, for U.S. healthcare providers (Nox Health). www.somryst.com/for-us-hcps
- U.S. Department of Veterans Affairs. Insomnia Coach (free app). mobile.va.gov/app/insomnia-coach
- U.S. Department of Veterans Affairs. CBT-i Coach (free app). mobile.va.gov/app/cbt-i-coach
- University of Virginia, Center for Behavioral Health & Technology. SHUTi: Sleep Healthy Using the Internet. med.virginia.edu/bht/shuti-sleep-healthy-using-the-internet/
- Espie CA, et al. (2019). Effect of digital cognitive behavioral therapy for insomnia on health, psychological well-being, and sleep-related quality of life: a randomized clinical trial. JAMA Psychiatry 76(1):21–30. pubmed.ncbi.nlm.nih.gov/30264137/
- Ritterband LM, et al. (2017). Effect of a web-based cognitive behavior therapy for insomnia intervention with 1-year follow-up: a randomized clinical trial. JAMA Psychiatry 74(1):68–75. pubmed.ncbi.nlm.nih.gov/27902836/
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