Sleep

A digital cognitive behavioural therapy programme for insomnia and anxiety in older adults: feasibility and preliminary efficacy.

Reyt M, Adoutoro J, et al. • Age and ageing • 2026

PubMed 42096653 DOI 10.1093/ageing/afag123
TL;DR

The eCBT+ programme was user-friendly and its use was acceptable in older adults with insomnia, and the programme improved sleep efficiency and reduced insomnia and anxiety symptoms, demonstrating the efficacy of our eCBT+ intervention.

Key Findings

Results

The eCBT+ platform was considered user-friendly by older adult participants.

  • System Usability Scale (SUS) score was 69.94%
  • Perceived ease of use, perceived usefulness, and result demonstrability were the main contributors to acceptability
  • Usability and acceptability were assessed post-intervention using the SUS questionnaire and the extended Technology Acceptance Model questionnaire
  • The sample consisted of 80 older adults with insomnia
Results

The eCBT+ intervention significantly reduced insomnia severity compared to the waitlist control group.

  • Insomnia symptoms were measured using the Insomnia Severity Index (ISI)
  • The Group*Time interaction was statistically significant (P < .001)
  • Analysis used linear mixed models with an intention-to-treat approach
  • 38 participants were randomised to eCBT+ and 42 to the waitlist control condition
Results

The eCBT+ intervention significantly reduced anxiety symptoms compared to the waitlist control group.

  • Anxiety symptoms were measured using the Geriatric Anxiety Inventory (GAI)
  • The Group*Time interaction was statistically significant (P < .001)
  • The programme was specifically designed to simultaneously address both insomnia and anxiety
  • Insomnia and anxiety are described as highly prevalent and often comorbid in older adults
Results

The eCBT+ intervention significantly increased sleep efficiency compared to the waitlist control group.

  • Sleep efficiency was derived from sleep diaries
  • The Group*Time interaction was statistically significant (P < .001)
  • Sleep efficiency was assessed at both baseline and follow-up
  • Analysis was conducted using linear mixed models with an intention-to-treat approach
Methods

The study was designed as a randomised controlled trial to assess feasibility, usability, acceptability, and preliminary efficacy of an online CBT programme targeting both insomnia and anxiety in older adults.

  • 80 older adults with insomnia were randomised: 38 to eCBT+ and 42 to waitlist control
  • The eCBT+ programme was developed to address the gap of interventions that simultaneously target insomnia and anxiety
  • The programme was designed to address limited access to CBT due to provider availability and high costs
  • Outcomes were assessed at baseline and follow-up
  • Trial registered at ISRCTN15338211

What This Means

This research suggests that an online cognitive behavioural therapy (CBT) programme called eCBT+, designed specifically for older adults, can effectively reduce both sleep problems and anxiety while being practical and easy to use. In a randomised controlled trial of 80 older adults with insomnia, those who used the eCBT+ programme showed significant improvements in sleep efficiency, insomnia severity, and anxiety symptoms compared to those on a waitlist who did not receive the intervention. The programme received a usability score indicating it was considered user-friendly, with participants finding it easy to use, useful, and able to demonstrate results. This research matters because insomnia and anxiety are very common in older adults and frequently occur together, yet most existing treatments address only one condition at a time. Traditional in-person CBT, while effective, is often difficult to access due to limited availability of trained providers and high costs. A digital programme that targets both conditions simultaneously could help many more older adults get the support they need from home. The findings suggest that web-based tools offer a promising approach to promoting sleep and mental health in older populations, even among those who may be less familiar with technology. This research provides preliminary evidence that digital CBT programmes are both acceptable to and effective for older adults, potentially opening the door to broader, more equitable access to evidence-based mental health care.

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Citation

Reyt M, Adoutoro J, Borgetto F, Desrosiers C, Barbaux L, Gong K, et al.. (2026). A digital cognitive behavioural therapy programme for insomnia and anxiety in older adults: feasibility and preliminary efficacy.. Age and ageing. https://doi.org/10.1093/ageing/afag123