Logging on for better sleep: RCT of the effectiveness of online treatment for insomnia.
OBJECTIVE
Despite effective cognitive behavioral treatments for chronic insomnia, such treatments are underutilized. This study evaluated the impact of a 5-week, online treatment for insomnia.


METHODS
This was a randomized controlled trial with online treatment and waiting list control conditions.


METHODS
Participants were 118 adults with chronic insomnia.


METHODS
Participants received online treatment from their homes.


METHODS
Online treatment consisted of psychoeducation, sleep hygiene, and stimulus control instruction, sleep restriction treatment, relaxation training, cognitive therapy, and help with medication tapering.


RESULTS
From pre- to post-treatment, there was a 33% attrition rate, and attrition was related to referral status (i.e., dropouts were more likely to have been referred for treatment rather than recruited from the community). Using a mixed model analysis of variance procedure (ANOVA), results showed that online treatment produced statistically significant improvements in the primary end points of sleep quality, insomnia severity, and daytime fatigue. Online treatment also produced significant changes in process variables of pre-sleep cognitive arousal and dysfunctional beliefs about sleep.


CONCLUSIONS
Implications of these findings are that identification of who most benefits from online treatment is a worthy area of future study.
Vincent
Norah
N
Department of Clinical Health Psychology, University of Manitoba, Manitoba, Canada.
Lewycky
Samantha
S
D000328:Adult; D002940:Circadian Rhythm; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D020407:Internet; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D012064:Relaxation Therapy; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D013813:Therapy, Computer-Assisted
D006993:Hypnotics and Sedatives