Background <p>Insomnia is a common health problem in the adult population, and nurse-led cognitive behavioral therapy (Nurse-led CBT-I) is considered an effective intervention. However, there is inconsistency in the findings of existing studies regarding the efficacy of CBT-I, with some studies demonstrating its effectiveness while others failing to observe a significant effect.</p> Aims <p>To explore the efficacy of nurse-led CBT-I in adults using meta-analysis.</p> Methods <p>Search of PubMed, Embase, Cochrane library, web of science databases for randomized controlled studies on the effect of nurses on insomnia was performed from the time of database creation to 25th of January 2025. Search terms used included “cognitive behavioral therapy”, “CBT-I”, and “insomnia”. In addition, we considered the gray literature and manually searched conference abstract and dissertation databases. The analysis was done using stata15 software and quality assessment was done using risk of bias.</p> Results <p>Ten articles involved 1537 patients, the results of meta-analysis suggest nurse-led CBT-I significantly reduced Pittsburgh Sleep Quality Index (PSQI) scores [SMD = -1.95, 95% CI (-3.20, − 0.71)], reduced Insomnia Severity Index (ISI) scores [SMD = -3.34, 95% CI (-5.26, -1.42)], improve quality of life (QOL) scores [SMD = 0.42, 95% CI (0.09, 0.75)], improve Sleep efficiency (SE) [SMD = 2.56, 95% CI (0.92, 4.20)]. However, there was no effect on Total sleep time (TST) [SMD =-0.09, 95% CI (-0.38, 0.20)].</p> Conclusion <p>Based on the results of the current study, nurse-led CBT-I may be effective for insomnia in adults, therefore, it is recommended that CBT-I be incorporated into nurses’ training programs to enhance their ability to intervene in the management of insomnia and to further promote the outcome of patients with insomnia. But due to the large limitations of the study, more high-quality, multicenter, large sample randomized controlled studies are needed to support our conclusions in the future.</p>