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Insomnia DisordersINSOMNIACNCT07794943

Internet-Based Cognitive Behavioral Therapy and Physical Activity for Insomnia

A study testing Internet-based cognitive behavioral therapy & physical ACtivity for INSOMNIa (iCBT-I-PA) and Behavioral: Internet-based cognitive behavioral therapy & physical ACtivity for INSOMNIa (iCBT-I) in people with Insomnia Disorders and Physical Inactivity, run by Uppsala County Council, Sweden at 1 site in Sweden.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Internet-based cognitive behavioural therapy for insomnia (iCBT-I) has shown promise for reducing insomnia symptoms. Additionally, physical activity has long been known to contribute to better sleep. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Insomnia Disorders, Physical Inactivity
What is being tested?
Internet-based cognitive behavioral therapy & physical ACtivity for INSOMNIa (iCBT-I-PA) and Behavioral: Internet-based cognitive behavioral therapy & physical ACtivity for INSOMNIa (iCBT-I)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
355 participants
Where
1 siteSweden
Study dates
Sep 2026to Dec 2032
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 18 years or older
  • Experiencing clinically relevant insomnia (Insomnia Severity Index score >10)
  • Do not meet the recommended levels of physical activity (weekly 150-300 minutes of moderate intensity physical activity or 75-150 minutes of vigorous physical activity)

Who cannot join

  • Have any ongoing diagnosed medical conditions known to affect PA participation as assessed by intervention clinician.
  • Increased risk for suicide as assessed by intervention clinician.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Sören Spörndly-Nees, PhD contact

+46 722073089

soren.sporndly-nees@regionuppsala.se

Sweden1 site
  • Primary care and health, Region Uppsala

    Uppsala

    Sören Spörndly-Nees, PhD, +47722073089, soren.sporndly-nees@regionuppsala.se

    Sören Spörndly-Nees, PhD

Other trials in Sweden

About this study

Internet-based cognitive behavioural therapy for insomnia (iCBT-I) has shown promise for reducing insomnia symptoms. Additionally, physical activity has long been known to contribute to better sleep. The current protocol describes a planned a two-phased project aiming to examine the effect of a randomised controlled trial, including iCBT-I (standard care) alone or with additional physical activity components (iCBT-I-PA). Adults with sleep problems and insufficient physical activity levels will be included in the 6-8-week intervention. Outcomes measured will include insomnia severity (primary outcome), physical activity, sedentary behaviour, psychological distress, cognitive function and quality of life. Measures will be taken at baseline, immediately post-intervention, and at 6- and 12-month follow-ups. We hypothesise that the iCBT-I-PA group will show greater reductions in insomnia severity and increase physical activity compared to the iCBT-I group.

Read the detailed description

Design and aims:

Internet-based cognitive behavioural therapy for insomnia (iCBT-I) has shown promise for treating insomnia. Physical activity has been proposed as a potential adjuvant to insomnia treatments as it has positive benefits for optimal sleep. An intervention has been developed that incorporates physical activity components into the standard iCBT-I (iCBT-I-PA). The current protocol describes the planned project which consists of two phases: Phase 1 will evaluate the feasibility and acceptability of iCBT-I-PA. The results of the feasibility and acceptability outcomes will inform adjustments to the study procedures ahead of the full-scale trial. Phase 2 will be a full-scale randomised controlled trial (RCT) with the aim to examine the effectiveness of iCBT-I-PA compared to iCBT-I as standard care (control).

Phase 1: A pilot RCT with the aims to:

  • study the feasibility regarding recruitment, randomization and adherence of study protocol.
  • analyse the within-group changes of sleep, physical activity, sedentary time, cognitive impairment, depression and anxiety, from baseline and directly after the intervention.
  • explore participants' experiences of the new treatment and of participating in the study including acceptance of study protocol.

Phase 2: An RCT with the aims to:

  • compare the effects of iCBT-i-PA and iCBT-i immediately after the intervention regarding self-reported and objective measured sleep, physical activity and sedentary time as well as self-reported cognitive impairment, depression, anxiety and pain.
  • compare the effect of iCBT-i-PA and iCBT-i 6 and 12 months after the intervention regarding self-reported and objective measured sleep, physical activity and sedentary time as well as self-reported cognitive impairment, depression, anxiety and pain.
  • evaluate the mediating role of the assessed outcomes on improved sleep.

Methods:

Adults (>18 years) with clinically relevant insomnia (Insomnia Severity Index; ISI; score ≥11) and who are insufficiently physically active (the Swedish National Board of Health and Welfare; NBHW; questions for physical activity; <150 min of moderate-vigorous physical activity) will be included. Eligible participants will complete baseline assessments before being randomised 1:1 to iCBT-I or iCBT-I-PA. Participants will be informed that they will receive an internet-based insomnia treatment but will be blinded to the specific intervention components and study hypotheses. The psychologists delivering the treatment and the team member managing randomisation will not be blinded after allocation.

The intervention will be conducted through the Swedish e-health system 1177 Stöd och Behandling (SoB; support and treatment). The treatment consists of 6 modules completed over 6-8 weeks with weekly assigned individual tasks along with evaluations by the psychologist. The iCBT-I will include education about insomnia, CBT-I strategies for better sleep, application of CBT strategies, and conclusion/summary of the treatment. The iCBT-I-PA will include additional physical activity components based on the Swedish model of physical activity on prescription (FaR), including assessments of physical activity level and health status, physical activity self-registration (diary), goalsetting, activity plan, follow-up, strategies for overcoming barriers, and evaluation.

Intervention outcomes will include the insomnia severity as the primary outcome, measured using the ISI. Sleep, physical activity and sedentary behaviour will be measured using diaries: the Physical Activity Diary (PAD) and the Swedish version of the Consensus Sleep Diary (S-CSD); the SENS Motion accelerometer, and the self-reported NBHW for physical activity and sedentary behaviour. Additionally, self-reported measures of cognitive function (Work Ability Index; WAI; and British Columbia Cognitive Complaints Inventory; BC-CCI), depression (Montgomery and Asberg Depression Rating Scale; MADRS), anxiety (Generalises Anxiety Disorder-7; GAD-7) and pain (Numeric Rating Scale for Pain; NRS) will be collected. The outcomes will be assessed at baseline, post-intervention, and at 6- and 12-month follow-ups.

Analysis approach:

Phase 1: Feasibility will be assessed through a number of trial process outcomes, including recruitment, retention, adherence and fidelity. Acceptability will be assessed though qualitative sub-study using semi-structured interviews with participants who were randomised to iCBT-I-PA. Preliminary, exploratory analyses will focus on within-group directional changes over time to help inform the full-scale intervention.

Phase 2: For the full-scale RCT, baseline demographics will be summarised descriptively by treatment condition. The analyses will include t-tests, linear mixed-effects models (LMM) and/or repeated measures analysis of variance (ANOVA) to compare the effects of iCBT-I and iCBT-I-PA. The effects will be examined as the immediate change from pre- to post-intervention, and long-term changes from pre-intervention to 6- and 12-month follow-up.

Being tested
Internet-based cognitive behavioral therapy & physical ACtivity for INSOMNIa (iCBT-I-PA), Behavioral: Internet-based cognitive behavioral therapy & physical ACtivity for INSOMNIa (iCBT-I)
Keywords
Insomnia, Sleep, Physical activity, iCBT-I, Digital intervention, Cognitive behavioural therapy
Medical subject headings
Sleep Initiation and Maintenance Disorders, Sedentary Behavior, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Internet-based cognitive behavioral therapy & physical ACtivity for INSOMNIa (iCBT-I-PA)Behavioural

    Experimental condition: Internet-based cognitive behavioural therapy targeting insomnia combined with physical activity support

  • Behavioral: Internet-based cognitive behavioral therapy & physical ACtivity for INSOMNIa (iCBT-I)Behavioural

    Standard care (control): Internet-based cognitive behavioural therapy targeting insomnia

Study groups in NCT07794943
Study groupRoleWhat they receive
iCBT-IActive comparatorStandard care (control): Internet-based cognitive behavioural therapy targeting insomnia
Receives: Behavioral: Behavioral: Internet-based cognitive behavioral therapy & physical ACtivity for INSOMNIa (iCBT-I)
iCBT-I-PAExperimentalExperimental condition: Internet-based cognitive behavioural therapy targeting insomnia combined with physical activity
Receives: Behavioral: Internet-based cognitive behavioral therapy & physical ACtivity for INSOMNIa (iCBT-I-PA)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Feasibility: Pilot RCT recruitment rate

    For Phase 1 pilot RCT only: Recruitment rate will be assessed as the average rate of participant recruitment as participants per week throughout the pilot RCT.

    Measurement tool: Study screening and enrolment log.

    Measured: Following recruitment to randomisation of the final pilot participant (up to 52 weeks).

  2. Feasibility: Pilot RCT consent rate

    For Phase 1 pilot RCT only: Consent rate will be assessed as the proportion of eligible/recruited participants who consent to participate.

    Measurement tool: Study screening and consent log.

    Measured: Following recruitment to randomisation of the final pilot participant (up to 52 weeks).

  3. Feasibility: Pilot RCT adherence rate

    For Phase 1 pilot RCT only: Intervention adherence will be assessed as the proportion of participants completing ≥3 modules (50% of intervention), the minimum number required for an expected change in insomnia outcomes.

    Measurement tool: The number of completed modules indicated by study clinician.

    Measured: Baseline and post-intervention measure (6-8 weeks)

  4. Feasibility: Pilot RCT data collection completion rate

    For Phase 1 pilot RCT only: Data collection completion will be assessed as the proportion of randomised participants who provide complete outcome data at baseline, post-intervention, 6 months, and 12 months.

    Measurement tool: the outcome assessment database.

    Measured: Baseline, post-intervention (6-8 weeks), 6- and 12-month follow-up

  5. Feasibility: Pilot RCT retention rate

    For Phase 1 pilot RCT only: Retention will be assessed as the proportion of randomised participants who have not withdrawn and who complete the follow-up assessments at 6 and 12 months.

    Measurement tool: The participant tracking and follow-up log.

    Measured: 6 and 12 months follow-up after intervention

  6. Feasibility: Pilot RCT intervention fidelity rate

    For Phase 1 pilot RCT only: Intervention fidelity will be assessed as the percentage of planned intervention components delivered as intended.

    Measurement tool: Study-specific intervention fidelity checklist completed by study clinicians and platform delivery records.

    Measured: Post-intervention (6-8 weeks)

  7. Acceptability: Pilot RCT acceptability of the iCBT-I-PA intervention assessed by semi-structured interview

    For Phase 1 pilot RCT only: Acceptability will be assessed using semi-structured interviews with participants randomised to the iCBT-I-PA condition who completed at least the baseline measures. Interviews will explore participants' experiences of the intervention and pilot RCT procedures, including acceptability of the intervention, randomisation, outcome assessments, follow-up schedule, and barriers and facilitators to engagement.

    Measurement tool: Semi-structured interview topic. Themes identified using thematic analysis.

    Measured: Post-intervention (6-8 weeks)

  8. Insomnia severity

    For Phase 1 pilot RCT and Phase 2 full-scale RCT: Insomnia severity will be the primary outcome that the intervention will aim to change. Insomnia severity will be measured using the Insomnia Severity Index (ISI). The ISI comprises seven items, measuring the severity and impact of insomnia and the extent to which it interferes with the individual's daily life. The ISI is scored on a 5-point Likert scale (0="Not at all", 4="Very much"). A sum score represents overall insomnia severity, ranging from 0 to 28.

    Measurement tool: The Insomnia Severity Index (ISI)

    Measured: Baseline, post-intervention (6-8 weeks), 6- and 12-month follow-up

Secondary outcomes (8)
  1. Sleep: Diary

    For Phase 1 pilot RCT and Phase 2 full-scale RCT: Sleep will be measured using a sleep diary: the Swedish version of the Core Consensus Sleep Diary (S-CSD). The S-CSD is a diary completed daily in the morning to assess nightly variation in sleep quality based on subjective sleep patterns. The S-CSD will yield Sleep Onset Latency, Wake After Sleep Onset, Total Sleep Time, Time in Bed, Sleep Efficiency, number of awakenings, and subjective sleep quality.

    Measurement tool: The Swedish version of the Core Consensus Sleep Diary

    Measured: Baseline, post-intervention (6-8 weeks), 6- and 12-month follow-up

  2. Sleep: Device-measured

    For Phase 1 pilot RCT and Phase 2 full-scale RCT: Sleep will be measured using a device-based measure, the thigh-worn triaxial SENS Motion® accelerometer. The accelerometer will be worn continuously for 9 consecutive days. Sleep metrics captured will be total sleep time, sleep onset/offset, sleep efficiency, and number of awakenings.

    Measurement tool: SENS Motion® accelerometer

    Measured: Baseline, post-intervention (6-8 weeks), 6- and 12-month follow-up

  3. Physical activity: Diary

    For Phase 1 pilot RCT and Phase 2 full-scale RCT: Physical activity will be measured using a physical activity diary. The physical activity diary will be completed over seven consecutive days. Physical activity metrics captured will be the types of physical activities, their duration (in minutes) and perceived exertion (the Borg Rating of Perceived Exertion scale; 6-20; 6=no exertion, 20=maximal exertion).

    Measurement tool: Physical Activity Diary (PAD)

    Measured: Baseline, post-intervention (6-8 weeks), 6- and 12-month follow-up

  4. Physical activity: Self-report

    For Phase 1 pilot RCT and Phase 2 full-scale RCT: Self-reported physical activity will be measured using a two-item questionnaire capturing the time (in minutes) spent weekly on daily-life physical activity and structured physical activity, respectively.

    For daily-life physical activity, response options will be 0, <30, 30-60, 60-90, 90-120 and >120 minutes.

    For structured physical activity, response options will be 0, <30, 30-60, 60-90, 90-150, 150-300 and >300 minutes.

    Measurement tool: the Swedish National Board of Health and Welfare questions for physical activity

    Measured: Baseline, post-intervention (6-8 weeks), 6- and 12-month follow-up

  5. Physical activity: Device-measured

    For Phase 1 pilot RCT and Phase 2 full-scale RCT: Device-based physical activity will be measured using the thigh-worn triaxial SENS Motion® accelerometer. The accelerometer will be worn continuously for 9 consecutive days. Physical activity metrics captured will be accelerations, steps, and daily minutes of light, moderate and vigorous physical activity.

    Measurement tool: SENS Motion® accelerometer

    Measured: Baseline, post-intervention (6-8 weeks), 6- and 12-month follow-up

  6. Sedentary behaviour: Diary

    For Phase 1 pilot RCT and Phase 2 full-scale RCT: A sedentary behaviour diary will be completed over seven consecutive days along with the physical activity diary. Sedentary behaviour metrics captured will be the duration of sitting, frequency of breaks in sitting, and the most common type of breaks across pre-defined segments of the day (i.e., morning, late morning, lunch, afternoon, dinner, evening, night).

    Measurement tool: Part of the Physical Activity Diary (PAD)

    Measured: Baseline, post-intervention (6-8 weeks), 6- and 12-month follow-up

  7. Sedentary behaviour: Self-report

    For Phase 1 pilot RCT and Phase 2 full-scale RCT: Self-reported sedentary behaviour will be measured using a single-item questionnaire capturing regarding the weekly time (in hours) spent sitting during waking hours.

    Response options will be Almost all day, 13-15, 10-12, 7-9, 4-6, 1-3 hours and Never.

    Measurement tool: Swedish National Board of Health and Welfare questions for sedentary behaviour (SED-GIH)

    Measured: Baseline, post-intervention (6-8 weeks), 6- and 12-month follow-up

  8. Sedentary behaviour: Device-measured

    For Phase 1 pilot RCT and Phase 2 full-scale RCT: Device-based sedentary behaviour will be measured using the thigh-worn triaxial SENS Motion® accelerometer. The accelerometer will be worn continuously for 9 consecutive days. Sedentary behaviour metrics captured will be total minutes of waking hours spent sedentary (sitting or reclining below 1.5 METs) and daily breaks in sedentary time.

    Measurement tool: SENS Motion® accelerometer

    Measured: Baseline, post-intervention (6-8 weeks), 6- and 12-month follow-up

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 Aug 2026
  2. Study startSep 2026 (estimated)
  3. Primary completionDec 2032 (estimated)
  4. Study completionDec 2032 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
355 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07794943
Sponsor's protocol ID
2024-04646-01
Other IDs
20243219
Acronym
INSOMNIAC
Status last verified
Aug 2026
First submitted
1 Jul 2026
Last updated
31 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Due to ethical and privacy restrictions, we do not plan on making IPD publicly available.

Questions about this trial

What is this clinical trial studying?

A study testing Internet-based cognitive behavioral therapy & physical ACtivity for INSOMNIa (iCBT-I-PA) and Behavioral: Internet-based cognitive behavioral therapy & physical ACtivity for INSOMNIa (iCBT-I) in people with Insomnia Disorders and Physical Inactivity, run by Uppsala County Council, Sweden at 1 site in Sweden.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 31 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Sören Spörndly-Nees, PhD (+46 722073089, soren.sporndly-nees@regionuppsala.se), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Feasibility: Pilot RCT recruitment rate (time frame: Following recruitment to randomisation of the final pilot participant (up to 52 weeks).). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Aug 2026; AzTrials last refreshed its copy on 30 Oct 2026.

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