Sweden tests digital sleep app in simple English to reach immigrant patients
Researchers piloted a streamlined insomnia treatment app written in simple English for non-Swedish speakers, addressing a critical gap in mental health access for linguistic minorities. The approach could model how health systems scale evidence-based care to underserved populations while reducing staff burden.
Originaltitel: Mind the gap: Pilot of the FastAsleep digital insomnia intervention in simple English for linguistic minorities in Sweden.
**Digital sömnterapi på enkelt engelska öppnar marknad för välfärdsöverenskommelser med flerspråkiga grupper** Karolinska Institutet testar FastAsleep, en digital interventions för insomnia, på enkelt engelska för invandrade personer i Sverige. Språkbarriärer hindrar miljontals från evidensbaserad kognitiv beteendeterapi för sömnproblem — en kommersiell lucka inom regionvård. Elva engelsktalande deltagare från tio länder genomförde den fyraveckorsintervention som fokuserar på sömnrestriktion. Resultaten visar högt genomförande, genomsnittligt endast 30 minuters personalresurs per patient, samt stora symtomlindring för insomnia (effektstorlek 1,55). Depressionsminskningen motsvarade den svenska versionen. Fyndet signalerar att multilingvala digitala insatser kan skalas kostnadseffektivt inom svenska regioner. För leverantörer av distanspsykiatri och hälsoteknikbolag öppnar detta vägen för efterfrågestyrd utveckling av evidensbaserade behov hos växande invandrarbefolkningar — utan betydande personalkostnader.
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.