LAUSR

Key Points Question Can clinical data be used to assess the effectiveness, durability, engagement, and adaptability of digital cognitive behavioral therapy for insomnia (dCBT-I)? Findings In this cohort study of 4052 patients with insomnia, dCBT-I was superior to medication therapy at 6-month follow-up, although results were found to be unstable. The combination of dCBT-I and medication resulted in a sustained improvement in sleep quality compared with monotherapy modalities. Meaning These findings suggest that dCBT-I needs to be thoughtfully combined with medication for long-term benefits in the treatment of insomnia and that further research into the design, implementation, and delivery of dCBT-I in terms of engagement and stability is required.