%0 Journal Article
%@ 1438-8871
%I JMIR Publications
%V 26
%N 
%P e50555
%T Efficacy of Mobile App–Based Cognitive Behavioral Therapy for Insomnia: Multicenter, Single-Blind Randomized Clinical Trial
%A Shin,Jiyoon
%A Kim,Sujin
%A Lee,Jooyoung
%A Gu,Hyerin
%A Ahn,Jihye
%A Park,Chowon
%A Seo,Mincheol
%A Jeon,Jeong Eun
%A Lee,Ha Young
%A Yeom,Ji Won
%A Kim,Sojeong
%A Yoon,Yeaseul
%A Lee,Heon-Jeong
%A Kim,Seog Ju
%A Lee,Yu Jin
%+ Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea, 82 2 2072 2456, ewpsyche@snu.ac.kr
%K digital therapeutics
%K mobile app–based cognitive behavioral therapy for insomnia
%K cognitive behavioral therapy
%K insomnia
%K mental health
%K mobile phone
%D 2024
%7 26.7.2024
%9 Original Paper
%J J Med Internet Res
%G English
%X Background: Cognitive behavioral therapy for insomnia (CBTi) is the first-line therapy for chronic insomnia. Mobile app–based CBTi (MCBTi) can enhance the accessibility of CBTi treatment; however, few studies have evaluated the effectiveness of MCBTi using a multicenter, randomized controlled trial design. Objective: We aimed to assess the efficacy of Somzz, an MCBTi that provides real-time and tailored feedback to users, through comparison with an active comparator app. Methods: In our multicenter, single-blind randomized controlled trial study, participants were recruited from 3 university hospitals and randomized into a Somzz group and a sleep hygiene education (SHE) group at a 1:1 ratio. The intervention included 6 sessions for 6 weeks, with follow-up visits over a 4-month period. The Somzz group received audiovisual sleep education, guidance on relaxation therapy, and real-time feedback on sleep behavior. The primary outcome was the Insomnia Severity Index score, and secondary outcomes included sleep diary measures and mental health self-reports. We analyzed the outcomes based on the intention-to-treat principle. Results: A total of 98 participants were randomized into the Somzz (n=49, 50%) and SHE (n=49, 50%) groups. Insomnia Severity Index scores for the Somzz group were significantly lower at the postintervention time point (9.0 vs 12.8; t95=3.85; F2,95=22.76; ηp2=0.13; P<.001) and at the 3-month follow-up visit (11.3 vs 14.7; t68=2.61; F2,68=5.85; ηp2=0.03; P=.01) compared to those of the SHE group. The Somzz group maintained their treatment effect at the postintervention time point and follow-ups, with a moderate to large effect size (Cohen d=–0.62 to –1.35; P<.01 in all cases). Furthermore, the Somzz group showed better sleep efficiency (t95=–3.32; F2,91=69.87; ηp2=0.41; P=.001), wake after sleep onset (t95=2.55; F2,91=51.81; ηp2=0.36; P=.01), satisfaction (t95=–2.05; F2,91=26.63; ηp2=0.20; P=.04) related to sleep, and mental health outcomes, including depression (t95=2.11; F2,94=29.64; ηp2=0.21; P=.04) and quality of life (t95=–3.13; F2,94=54.20; ηp2=0.33; P=.002), compared to the SHE group after the intervention. The attrition rate in the Somzz group was 12% (6/49). Conclusions: Somzz outperformed SHE in improving insomnia, mental health, and quality of life. The MCBTi can be a highly accessible, time-efficient, and effective treatment option for chronic insomnia, with high compliance. Trial Registration: Clinical Research Information Service (CRiS) KCT0007292; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=22214&search_page=L 
%R 10.2196/50555
%U https://www.jmir.org/2024/1/e50555
%U https://doi.org/10.2196/50555