A bad night can make the next day feel smaller. After many bad nights, even starting a programme can feel like a lot. This trial found real improvement for some autistic adults. It also reminds us that useful support has to be possible to live with.
- The online programme reduced insomnia more than information alone.
- It did not clearly improve anxiety, depression or daily functioning.
- Half completed every module, so flexibility still matters.
Questions you can take with you
You do not need to become an expert. These questions can help you talk with a professional or support provider.
- Can I use this at a pace that works for me?
- What happens if a module is tiring or does not fit?
- Have other reasons for poor sleep been considered too?
Want the study details?Sample, method and evidence type
- Adults randomized
- 163
- Programme
- 5 weeks
- Meaningful improvement
- 37.8% vs 11.1%
Read on for what was studied, what was found and what remains uncertain.
When sleep advice is not enough
Insomnia is not always fixed by a darker room or putting the phone away. Many autistic adults already know the usual advice. The harder part can be finding support that fits sensory needs, routines, energy and the way a person processes information.
The researchers adapted an existing online sleep programme with seven autistic adults who had sleep problems. That matters. It does not make the programme right for everyone, but it means the changes were not imagined without autistic people in the room.
What the trial did
The study included 163 autistic adults with insomnia. Eighty-two were offered the guided five-week programme. Eighty-one joined a waiting-list group and received information about sleep and sleep hygiene.
People were placed in the groups at random. The main question was whether their insomnia score changed after six weeks. The researchers also looked at what happened before sleep, quality of life, anxiety, depression and daily functioning.
What changed — and what did not
Insomnia improved more in the programme group. At six weeks, 37.8% had reached an improvement the researchers considered meaningful. That was 11.1% in the waiting-list group. The improvement in insomnia was still present at the six-month follow-up for the people who had received the programme.
Quality of life was also better just after the programme. But the study did not find a clear change in anxiety, depression or daily functioning. Better sleep did not automatically make every other difficulty better.
The unfinished modules matter too
Just over half of the programme group completed at least four modules. Half completed all five. That is not a small footnote. An online tool can still ask for time, attention and energy when someone is already tired.
This study gives a useful option, not a rule. It does not show that every sleep app works, or that an online programme should replace a conversation about pain, breathing, medication, the sleep environment or other possible reasons for poor sleep.
Limitations to keep in view
- The comparison group was waiting for the programme; it did not receive another equally intensive treatment.
- Most outcomes were self-reported, and only half of the programme group completed every module.
- The six-month result shows maintenance after the programme, not a continuing randomized comparison with the waiting-list group.
- One adapted programme cannot tell us whether a different app, course or unguided tool will help.
Effectiveness of Guided Internet-delivered Cognitive Behavioral Therapy for Insomnia in Autistic Adults (i-Sleep Autism): a Randomized Controlled Trial
Spaargaren KL, Begeer S, Nieuwenhuis S, Bradley J, Riper H, Greaves-Lord K, van Straten A
SLEEP · 2026
This article provides general information and does not replace individualized medical, psychological or educational advice.