Digital insomnia therapy works for troops, and it lasts

Insomnia is highly prevalent in armed forces and veteran populations, where it undermines both operational readiness and quality of life. Cognitive behavioural therapy for insomnia is the recommended first-line treatment, but access is limited in military settings, where trained therapists are scarce and schedules unforgiving. Digital versions of the therapy promise scale by delivering the same structured programme through a screen, yet the evidence in military populations had never been systematically pulled together. This review asked a direct question: does digital CBT-I actually reduce insomnia severity in serving personnel and veterans?

The authors searched multiple electronic databases and grey literature between July and August 2025 for randomised controlled trials in armed forces personnel with insomnia, identified either by DSM-5 criteria or an Insomnia Severity Index score of 14 or more. Digital CBT-I interventions were compared with minimum contact controls, and participants were included regardless of age, duty status, comorbidities or setting. Five trials qualified, covering 309 people receiving the therapy and 249 controls. Changes in insomnia severity scores after treatment were pooled with random-effects models, risk of bias was formally assessed, and follow-up results were examined descriptively.

Digital CBT-I produced a statistically significant moderate-to-large reduction in insomnia severity compared with control conditions. The trials varied substantially in their results, with much of that variation traced to a single study; removing it sharply reduced the disagreement while the overall effect stayed robust. Three studies reported reductions of at least 6 points on the insomnia scale, a threshold considered clinically meaningful. Where follow-up data were available, treatment gains held for up to 12 months. Against that, the overall risk of bias was unclear or high, driven mainly by limited reporting and participant dropout, and the certainty of the evidence was rated moderate.

Digital CBT-I already has support in civilian populations, and this review extends that support into a group with complex health needs and structural barriers to face-to-face care. It confirms the direction of the civilian evidence while flagging the field's weak spots: only five trials existed to pool, attrition was a recurring problem, and the authors call for future work on engagement and dropout within digital therapeutics. How best to implement these programmes inside military systems, and whether effects differ between serving personnel and veterans, remain open questions.

If your sleep is wrecked by shift work, stress or an irregular life, this is evidence that a structured digital programme can genuinely reduce insomnia rather than just soften it temporarily, and that the benefit can persist well beyond the programme itself. The population studied was military, but the finding speaks to anyone who cannot easily reach face-to-face therapy. The trials had real weaknesses around dropout and reporting, so the size of benefit any individual should expect remains uncertain.