Effectiveness of guided internet-delivered cognitive behavioral therapy for insomnia in autistic adults (i-Sleep Autism): a randomized controlled trial.

In 30 seconds

This randomized controlled trial evaluated a 5-week, guided internet-delivered cognitive behavioral therapy intervention adapted for autistic adults with insomnia. Among 163 participants, i-Sleep Autism was compared with a waitlist control receiving psychoeducation and sleep hygiene. Insomnia severity was significantly lower in the intervention group at mid-intervention and post-test (d = 1.02, 95%CI = [0.65, 1.40]); 37.8% versus 11.1% showed clinically meaningful improvement at post-test. Improvement in insomnia severity was maintained at 6-month follow-up. Quality of life also improved, while anxiety, depression, and daily functioning did not show significant effects.

Key findings

• Insomnia severity improved significantly versus control at mid-intervention and post-test (d = 1.02, 95%CI = [0.65, 1.40]).
• At post-test, clinically meaningful insomnia improvement occurred in 37.8% of the intervention group versus 11.1% of controls.
• Insomnia improvements were maintained at 6-month follow-up; quality of life was higher at post-test.
• No significant effects were found for anxiety, depression, or daily functioning.

Why it matters

The trial provides controlled evidence that a guided digital insomnia intervention adapted with autistic adults can improve insomnia symptoms, with benefits persisting at follow-up. The findings address a population with substantial insomnia burden and limited evidence for tailored sleep interventions. However, the absence of significant changes in daily functioning and mental health outcomes means that sleep improvement should not be assumed to translate into broader benefits.

What to keep in mind

Engagement was incomplete: 56.1% completed four modules and 50% completed all five. The abstract also reports no significant effects on daily functioning, anxiety, or depression.