Mind the gap: Pilot of the FastAsleep digital insomnia intervention in simple English for linguistic minorities in Sweden

Background Insomnia is a pervasive global mental health issue, and interventions based on Cognitive Behavioural Therapy for Insomnia (CBT-I) are the recommended first-line treatment. However, barriers such as language skills often prevent linguistic minority populations from accessing CBT-I, exacerbating a significant treatment gap. FastAsleep is a Swedish brief digital self-guided behavioural intervention for insomnia. Aims This study aimed to investigate the feasibility of providing FastAsleep in simple English as a proof-of-concept, to enable multilingual access to scalable evidence-based insomnia care for non-Swedish speakers living in Sweden. Methods We conducted a single-group pilot study recruiting 11 English-speaking participants nationwide in Sweden via online advertisements. The 4-week, self-guided, sleep-restriction-focused intervention required only brief onboarding and follow-up check-ins via phone with study personnel. Adherence data and self-reported outcomes (e.g., insomnia severity, depression, anxiety) were collected digitally, and all time spent by staff on communication was registered. Trial registered at OSF ( https://osf.io/ahvf6 ). Results The participants were born across ten different countries. Adherence to the intervention was high, and staff time averaged only 30 min per participant. Intervention credibility and English material quality were rated as high. Preliminary outcomes showed large reductions in symptoms of insomnia severity (within-group effect size [95% CI] 1.55 [0.59, 2.47]) and reductions in depression similar to FastAsleep in Swedish, but anxiety reductions were seemingly smaller. Conclusions The results demonstrate that FastAsleep, as a multilingual approach to digital insomnia care, is feasible and preliminary resource-efficient.