Exploring the effect of a culturally adapted and personalized digital CBT-I app in insomnia patients with mild-to-moderate OSA: a secondary analysis of a randomized controlled trial

This self-guided, culturally adapted, and personalized dCBT-I effectively improved insomnia severity, sleep quality, and depressive symptoms among individuals with COMISA. While treatment effects were comparable between COMISA and insomnia-alone groups, the observed numerical differences may reflect limited statistical power. Larger studies are warranted to determine whether individuals with comorbid obstructive sleep apnea respond differently to dCBT-I. Key messages What is already known on this topic: Cognitive behavioral therapy for insomnia may improve outcomes in patients with comorbid insomnia and sleep apnea. What this study adds: This study shows that an interactive, personalized, and culturally adapted digital cognitive behavioral therapy for insomnia program is also effective for comorbid insomnia and sleep apnea patients. How this study might affect research, practice, or policy: These findings support broader implementation of tailored digital cognitive behavioral therapy for insomnia in the treatment of comorbid insomnia and sleep apnea.