Digital Cognitive Behavioural Therapy for Insomnia in People with Co-Morbid Insomnia and Sleep Apnoea (COMISA): Recent Evidence and Clinical Considerations

Purpose of Review Comorbid insomnia and sleep apnoea (COMISA) is a prevalent and debilitating sleep condition that can be difficult to manage. Cognitive Behavioural Therapy for insomnia (CBTi) is an effective yet largely inaccessible treatment for insomnia in the presence of treated and untreated sleep apnoea. Self-guided and clinician-guided digital CBTi programs are becoming increasingly available, and may improve access to CBTi in patients with COMISA. This article reviews evidence of digital CBTi programs in the management of COMISA, presents a pro-con debate about digital CBTi for COMISA, and offers additional considerations and future research recommendations. Recent Findings Emerging evidence indicates that digital CBTi programs tailored for COMISA may be an effective and safe treatment for many patients with COMISA. However, specific safety and efficacy considerations are appropriate. Summary With identification and referral of appropriate patients, clinical oversight, and tailoring of digital treatment algorithms in the context of COMISA, there is potential that digital CBTi options will rapidly improve access to evidence-based CBTi pathways for people with COMISA.