Online CBT-I and Insomnia Apps: What Works and What to Look For

If you lie awake for hours or wake at 3 a.m. and can’t get back to sleep, you’ve probably seen insomnia apps advertised. Some deliver cognitive behavioral therapy for insomnia (CBT-I), a structured program that changes sleep habits and thoughts. Others mostly offer sounds or meditations. Our guide to insomnia and CBT-I explains the therapy itself.

Does online CBT-I work?

• A 2016 review of 11 randomized trials with 1,460 people found online CBT-I improved insomnia severity, time to fall asleep, time awake at night and total sleep. The effects were similar to in-person CBT-I and generally lasted 4 to 48 weeks.¹
• Longer programs and more personal support were linked to bigger improvements.¹
• A 2019 trial of 1,711 people found a digital CBT-I program delivered by web or phone improved daily functioning, well-being and sleep-related quality of life more than sleep hygiene education.²
• In breast cancer survivors, a fully automated six-part online program improved insomnia severity and fatigue in a trial of 255 women, and the gains lasted.³

How to spot a CBT-I program

A program delivering CBT-I typically includes:

1. A sleep diary you fill in daily.
2. A sleep schedule that adjusts your time in bed based on your diary. Our article on sleep restriction safety covers this step.
3. Rules for the bed: get up if you can’t sleep, use the bed only for sleep and sex.
4. Help with racing thoughts and worries about sleep.
5. Several weekly sessions, not a one-time video.

Sounds, stories and meditations can be relaxing, but on their own they aren’t CBT-I.

Questions before you pay

• Is it based on CBT-I, and has it been tested in published trials?
• Is there coaching or clinician support? More support was linked to better results.¹
• What does it cost, and is it covered by your plan or employer?
• How is your sleep and health data used?

When an app isn’t enough

Talk with a clinician if insomnia comes with loud snoring or breathing pauses, low mood, or menopause symptoms such as night sweats that wake you. Our guide to nighttime sleep aids after 50 explains why many over-the-counter pills aren’t a good long-term fix.

Try: “I’ve had insomnia for months. Would an online CBT-I program be right for me, or should we check for sleep apnea or menopause-related causes first?”

Did I Do That in My Sleep? includes a 14-Night Lights-Out Record and a Visit Brief. Use them alongside any program to track your sleep and share progress with your clinician. See the book.