This study is a multicenter, single-arm, prospective clinical trial designed to observe the long-term safety and effectiveness of the digital medical device BELL-001 in patients diagnosed with insomnia. Insomnia is a common sleep disorder that can significantly affect daytime functioning, mood, and overall quality of life. Many patients continue to experience difficulties despite lifestyle modifications or pharmacological treatment, and there is a growing need for safer, non-pharmacological therapeutic options.
BELL-001 is a smartphone-based therapeutic device that delivers personalized auditory stimulation during the pre-sleep period. The device is designed to promote relaxation and support the transition into sleep by analyzing individual breathing patterns and providing synchronized sound feedback. This study evaluates the long-term safety and effectiveness of BELL-001 over approximately 3 months (12 weeks) of use.
Forty adults diagnosed with insomnia will participate as the BELL-001 group. Participants will use the device for 12 weeks. During the study period, insomnia severity, depression, anxiety, and work productivity will be assessed. The outcome measures include changes in the Insomnia Severity Index (ISI), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Work Productivity and Activity Impairment Questionnaire (WPAI) at 4, 8, and 12 weeks compared to baseline; changes in Total Sleep Time (TST), Sleep Onset Latency (SOL), Wake After Sleep Onset (WASO), and sleep stage ratios measured via Nearable Device at 4, 8, and 12 weeks; and changes in subjective Sleep Latency (sSL), subjective Sleep Quality (sSQ), subjective Wake After Sleep Onset (sWASO), subjective number of awakenings after sleep onset, subjective Sleep Efficiency (sSE), and subjective Total Sleep Time (sTST) assessed through sleep diaries at 4, 8, and 12 weeks compared to baseline. Safety will be evaluated over the 12-week period. Additional outcome measures will include assessment of compliance and satisfaction.
This clinical trial is conducted at multiple hospitals in Korea and adheres to ethical guidelines, including review and approval by Institutional Review Boards (IRBs). Participation is voluntary, and all individuals will provide informed consent prior to the initiation of any study procedures. The results of this study are expected to provide key evidence for the clinical application of a digital, non-pharmacological intervention for adults with insomnia.
Diagnosed with ICD-10 nonorganic insomnia (F51.0) or sleep initiation and maintenance disorder (insomnia, G47.0)
Insomnia Severity Index (ISI) score ≥ 15
Adults aged 19 to 75 years
Capable of using a smartphone or tablet and has access to a stable internet connection
Individuals with severe psychiatric disorders, including major depressive disorder
Individuals diagnosed with or suspected of having insomnia comorbid with narcolepsy (G47.4), obstructive sleep apnea (G47.30), restless legs syndrome (G25.81), periodic limb movement disorder (G47.61), or REM sleep behavior disorder (G47.52) per ICD-10-CM codes
Individuals with active physical illness or unstable medical conditions that interfere with activities of daily living, including congestive heart failure, chronic obstructive pulmonary disease (COPD), acute pain, cerebrovascular disease (e.g., stroke), or neurodegenerative disorders (e.g., dementia, multiple sclerosis)
Individuals whose insomnia symptoms are considered to be caused or exacerbated by the physiological effects of medications (prescription drugs or substances of abuse) or alcohol
Single group
BELL-001 Digital Therapeutic
DeviceParticipants assigned to the experimental arm will use BELL-001, a smartphone-based digital therapeutic designed to provide personalized auditory stimulation synchronized with the user's breathing pattern. Participants will use the device nightly during the pre-sleep period for 12 weeks. The active algorithm delivers respiratory-synchronized auditory feedback intended to reduce pre-sleep hyperarousal and support sleep initiation.
Safety data from 12 weeks of BELL-001 use
All adverse events and device deficiencies occurring during this clinical trial
Change in Insomnia Severity Index (ISI) Score
The Insomnia Severity Index (ISI) is a validated 7-item patient-reported questionnaire that assesses nighttime symptoms, sleep satisfaction, and the impact of insomnia on daytime functioning. Higher scores indicate greater insomnia severity. This outcome measure evaluates the change in ISI total score from baseline to Weeks 4, 8, and 12.
Change in Depressive Symptoms (PHQ-9)
Change in PHQ-9 score to evaluate depressive symptom severity.
Change in Anxiety Symptoms (GAD-7)
Change in GAD-7 score reflecting the severity of generalized anxiety
Change in Work Productivity and Activity Impairment (WPAI-GH)
Change in absenteeism, presenteeism, and activity impairment related to general health.
User Response Assessment (compliance and satisfaction with usability)
User Response Assessment (compliance and satisfaction with usability)
Respiratory acoustic data collected via smartphone microphone
Respiratory acoustic data collected via smartphone microphone
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