The Efficacy of Therapist-Guided, Internet-Delivered Mindfulness-Based Cognitive Therapy for Chronic Insomnia Disorder: A Randomized Controlled Trial.
Zixuan Zeng, Jiahui Jiang, Kun Xie, Na Luo, Xiaofeng Guan, Chenyi Zhu, Zheng Lu, Lei Huang
Nature and Science of Sleep February 4, 2026 DOI: 10.2147/nss.s578770 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Open-label, parallel-group randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 82 |
| Population | Adults with Chronic Insomnia Disorder (CID) |
| Intervention | Mindfulness-Based Cognitive Therapy for Insomnia (iMBCT-I) |
| Duration | 8-week intervention, 20-week follow-up |
| Measures | Insomnia Severity Index (ISI), sleep diary, actigraphy, depressive and anxious symptom measures, quality of life measures |
| Topics | Meditation |
| Keywords | Insomnia Randomized controlled trial Cognitive behavioral therapy |
| Key findings | Therapist-guided, internet-delivered mindfulness-based cognitive therapy for insomnia (iMBCT-I) reduced insomnia severity more than sleep hygiene education at week 8 (mean ISI difference 4.00 points, Cohen's d 0.99) and produced higher remission rates (odds ratio 6.21), with additional benefits for sleep quality, sleep onset latency, wakefulness after sleep onset, sleep efficiency, REM duration, depressive symptoms, and physical and mental quality of life; most effects were maintained at 20 weeks. |
Abstract
Purpose: Chronic Insomnia Disorder (CID) is prevalent, yet access to effective treatments is limited. Integrating mindfulness with Cognitive Behavioral Therapy for Insomnia (CBT-I) in an accessible online format may fill this gap. This study evaluated the efficacy of a therapist-guided, internet-delivered Mindfulness-Based Cognitive Therapy for Insomnia (iMBCT-I), which has been scarcely investigated. Patients and
Methods: In this open-label, parallel-group randomized trial, 82 participants with CID were assigned to the 8-week of iMBCT-I group (n = 41) or a control group receiving a single online session of sleep hygiene education (SHE, n = 41). The primary outcomes were insomnia severity assessed with Insomnia Severity Index (ISI) and insomnia remission (ISI < 8) rate. Secondary outcomes included sleep quality, sleep diary and actigraphy parameters, depressive and anxious symptoms, and quality of life. The primary and the follow-up time-points were week 8 and week 20, respectively. Statistical analyses followed the intention-to-treat principle.
Results: No serious adverse events were reported. At week 8, the ISI score in the iMBCT-I group showed a significant decrease compared to the SHE group [mean difference, 95% confidence intervals (CI) = 4.00 (2.22, 5.78), p < 0.001, Cohen's d, 95% CI = 0.99 (0.53, 1.45)]. More participants achieved insomnia remission in the iMBCT-I group [odds ratio, 95% CI = 6.21 (2.24, 17.23), p < 0.001]. The iMBCT-I was also superior on improving sleep quality, sleep onset latency, wakefulness after sleep onset, sleep efficiency, rapid eye movement duration, depressive symptoms and both physical and mental quality of life (all p < 0.05). Linear mixed-effects model showed the maintenance of these effects at the 20-week follow-up for most outcomes.
Conclusion: Therapist-guided iMBCT-I is effective in reducing insomnia severity in adults with CID with benefits sustained for 20 weeks.
Trial Registration: This study has been registered with the Chinese Clinical Trial Registry https://www.chictr.org.cn/ (Registration Number: ChiCTR2400084300).
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cites 10
- Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology 2000
- A Randomized Controlled Trial of Mindfulness Meditation for Chronic Insomnia Sleep August 29, 2014
- Mindfulness-based cognitive therapy improves insomnia symptoms in individuals with recurrent depression: secondary analyses from a randomized controlled trial. Frontiers in Psychiatry 2023
- Effectiveness and Mechanisms of a Digital Mindfulness-Based Intervention for Subthreshold to Clinical Insomnia Symptoms in Pregnant Women: Randomized Controlled Trial. Journal of Medical Internet Research May 5, 2025
- A guided internet-delivered mindfulness-based cognitive therapy for insomnia: study protocol for a randomized controlled study. Frontiers in Psychiatry 2025
and 5 more in the library