Background: Wearable devices are increasingly used for sleep monitoring and as adjunctive treatment. Existing meta-analyses mostly pool composite digital therapies and rarely isolate stand-alone wearables or distinguish between objective and subjective end points. Whether stand-alone wearable interventions improve sleep outcomes in adults with insomnia, and which factors moderate treatment heterogeneity, remains unclear. Objective: This study aims to evaluate the effectiveness of wearable digital interventions on sleep outcomes in adults with insomnia versus control strategies and explore moderators of effectiveness, including device-wearing position, intervention duration, and control type, using meta-regression. Methods: This systematic review and meta-analysis was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‑Analyses) 2020 statement and the PRISMA-S (Preferred Reporting Items for Systematic Reviews and Meta‑Analyses Literature Search Extension) guideline. Five electronic databases and clinical trial registries were searched from inception to May 18, 2026. Eligible studies were randomized controlled trials (RCTs) evaluating wearable digital interventions in adults with insomnia compared with sham, waitlist, usual care, or active control conditions and had an intervention duration of at least 1 week. Study screening, data extraction, and risk-of-bias assessment were carried out independently by 2 reviewers. Pooled estimates were calculated using a restricted maximum likelihood random-effects model with the Hartung-Knapp-Sidik-Jonkman correction. Heterogeneity was assessed using the ² statistic, and 95% prediction intervals (PIs) were calculated for the primary analyses. The certainty of evidence was rated using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Results: Sixteen RCTs (N=910) were included. Wearable digital interventions were associated with a significant reduction in objective sleep-onset latency (SOL; mean difference [MD] −4.52, 95% CI −8.38 to −0.67, PI −9.52 to 0.47 min) and a significant improvement in subjective sleep efficiency (SE; MD 2.00%, 95% CI 1.90%‐2.11%, PI 1.85%‐2.15%). Subjective total sleep time (TST) also showed a significant increase (MD 19.11, 95% CI 2.98‐35.24, PI −16.20 to 54.43 minutes). Meta-regression showed that control type, intervention duration, and device location did not explain the heterogeneity of the insomnia severity index (ISI) (=0). Sensitivity analysis confirmed the robustness of pooled ISI estimates, and an Egger test indicated no small-study effects (=.07). Certainty of evidence ranged from moderate to high. Conclusions: Wearable digital interventions provide selective benefits for objective SOL, subjective SE, and subjective TST in adults with insomnia, with no improvement in overall ISI. Despite statistically significant effects on several sleep parameters, wide PIs, substantial heterogeneity, and limited study numbers indicate preliminary, nonconclusive findings. Wearables should be viewed as affordable adjunctive tools requiring further validation, not substitutes for first-line cognitive behavioral therapy for insomnia. Large-scale, long-term RCTs with standardized protocols and patient-level external validation are required to consolidate the evidence base. Trial Registration: PROSPERO CRD420251038603; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251038603

arXiv:2509.23067v2 Announce Type: replace-cross Abstract: The rising cost of acquiring supervised data has driven significant interest in self-improvement for large language models (LLMs). Straightforward unsupervised signals like majority voting have proven effective in generating pseudo-labels for verifiable tasks, while their applicability to unverifiable tasks (e.g., translation) is limited by the open-ended character of responses. As a result, self-evaluation mechanisms (e.g., self-judging and entropy minimization) are predominantly used to derive pseudo-labels. However, self-evaluation relying on LLMs typically incurs high computational overhead and introduces overconfidence issues due to intrinsic biases. To address these challenges, we propose a novel self-evaluation-free approach for unverifiable tasks, designed for lightweight yet effective self-improvement. Inspired by majority voting commonly employed in verifiable tasks, we propose semantic voting as a novel mechanism that relaxes the principle of hard matching (i.e., exact matching) toward soft matching (i.e., semantic similarity). Soft matching is achieved by leveraging a lightweight sentence embedding model to quantify semantic similarity, thereby mitigating excessive computational burden and intrinsic bias-associated limitations of self-evaluation. Comprehensive experiments demonstrate that our method achieves substantial gains in computational efficiency and overall better performance than self-evaluation methods across diverse model architectures and tasks.

arXiv:2602.20980v2 Announce Type: replace-cross Abstract: Multimodal Large Language Models (MLLMs) have achieved remarkable performance by integrating powerful language backbones with large-scale visual encoders. Among these, latent Chain-of-Thought (CoT) methods enable implicit reasoning in continuous hidden states, facilitating seamless vision-language integration and faster inference. However, existing heuristically predefined supervision signals in latent CoT provide limited guidance for preserving critical visual information in intermediate latent states. To address this limitation, we propose CrystaL (Crystallized Latent Reasoning), a single-stage framework with two paths to process intact and corrupted images, respectively. By explicitly aligning the attention patterns and prediction distributions across the two paths, CrystaL crystallizes latent representations into task-relevant visual semantics, without relying on auxiliary annotations or external modules. Extensive experiments on perception-intensive benchmarks demonstrate that CrystaL consistently outperforms state-of-the-art baselines, achieving substantial gains in fine-grained visual understanding while maintaining robust reasoning capabilities.