0439 Offering Immediate Digital CBT-I at First Contact Triples Treatment Adoption Compared with Traditional Referral-Dependent Pathways

Abstract Introduction Cognitive Behavioral Therapy for Insomnia (CBT-I) is the first-line treatment for chronic insomnia, yet real-world adoption remains low, with only 10–20% of referred patients initiating therapy. Common barriers include long wait times, multi-step referral processes, and limited access to behavioral sleep clinicians. To reduce these structural obstacles, our sleep center implemented an Immediate Digital CBT-I Access model, offering same-day enrollment in an evidence-based digital CBT-I program at the time of first patient contact. This study evaluated treatment adoption under this rapid-access approach. Methods We retrospectively reviewed consecutive adults who contacted a sleep center with insomnia as their primary complaint (N=50). All callers were offered immediate enrollment into a structured, clinician-supported digital CBT-I platform during the initial interaction, without requiring a prior sleep medicine consultation. Adoption was defined as completing intake and initiating the digital program. Patients who declined, cancelled, or did not engage were classified as non-adopters. All data were de-identified. Results Of 50 adult callers, 29 (58%) accepted immediate access and initiated digital CBT-I, while 21 (42%) declined or did not proceed. Adoption rates in this immediate-access model were approximately 3–5 times higher than the 10–20% uptake typically reported in referral-based pathways. Among adopters, treatment commonly began within 0–7 days of first contact, effectively removing the multi-week delay inherent to traditional consult-before-referral workflows. Conclusion Providing immediate digital CBT-I at first contact yielded a 58% adoption rate, substantially exceeding real-world uptake under standard referral systems. These results suggest that structural barriers—rather than patient resistance—are the primary drivers of low CBT-I utilization. A rapid-access, digital-first model may offer a scalable strategy to expand delivery of evidence-based insomnia care. Future analyses will evaluate treatment outcomes, patient satisfaction, and cost-effectiveness as additional participants complete the program. Support (if any)