Abstract
BACKGROUND: Insomnia disorder exhibits complex manifestations and heterogeneous clinical trajectories. Accurate subtyping of insomnia might enhance understanding of its clinical presentations and facilitate precision management. The Digital Multi-modal approaches to Subtyping Insomnia disorder (DIMOSI) study is a national prospective cohort study utilizing multi-modal assessments to explore the subtypes of insomnia disorder, their natural trajectories, and related mental health outcomes. METHODS: A total of 4,000 adult participants meeting International Classification of Sleep Disorders, 3rd Edition (ICSD-3) criteria for insomnia disorder will be recruited from community or clinical settings. Eligible participants will be invited to complete the multi-dimensional assessments via a digital platform, including a structured interview, questionnaires, cognitive tasks, sleep-activity diary, physiological characteristics, and ecology momentary assessments, as well as 7-day physical activity and sleep tracking using wearable devices. All participants will be followed up at 6 and 12 months. The primary outcome is the identification of multi-modal subtypes of insomnia disorder and their correlates. Secondary outcomes include the longitudinal trajectories of these subtypes, associated risk factors, and mental health outcomes. RESULTS: As of June 30, 2025, a total of 2937 patients with insomnia disorder have been recruited, with a mean age of 37.3 years (SD = 12.6), 59.3% from outpatient clinics, and 66.5% female. Among the participants, 2850(97.1%) were suffering from current insomnia disorder, while the mean score of the ISI was 15.5 ± 5.8. A total of 2134 participants (72.7%) wore accelerometers, while 2429 (82.7%) wore wearable EEG monitors for continuous assessments. DISCUSSION: The DIMOSI study is a large-scale national prospective cohort investigating insomnia disorder utilizing a self-developed digital multi-modal platform. It integrates comprehensive subjective and objective assessments from 33 centers in China. The current study offers a unique opportunity to explore subtypes of insomnia disorder and their natural course and their correlates through the digital multi-modal platform that provides enriched and comprehensive assessments. It may provide the potential to inform the development of personalized prevention and intervention strategies, ultimately improving patient outcomes. TRIAL REGISTRATION: Clinical Trial Registry Name: Digital Multi-modal approaches to deep phenotyping insomnia disorder. Registration Number: ChiCTR2200056425. Date of Registration: 2022-02-05. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07648-9.