title: Guided Online or Face-to-Face Cognitive Behavioral Treatment for Insomnia: A Randomized Wait-List Controlled Trial.
abstract: OBJECTIVE
  To compare the efficacy of guided online and individual face-to-face cognitive behavioral treatment for insomnia (CBT-I) to a wait-list condition.
  
  
  METHODS
  A randomized controlled trial comparing three conditions: guided online; face-to-face; wait-list. Posttest measurements were administered to all conditions, along with 3- and 6-mo follow-up assessments to the online and face-to-face conditions. Ninety media-recruited participants meeting the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for insomnia were randomly allocated to either guided online CBT-I (n = 30), individual face-to-face CBT-I (n = 30), or wait-list (n = 30).
  
  
  RESULTS
  At post-assessment, the online (Cohen d = 1.2) and face-to-face (Cohen d = 2.3) intervention groups showed significantly larger treatment effects than the wait-list group on insomnia severity (insomnia severity index). Large treatment effects were also found for the sleep diary estimates (except for total sleep time), and anxiety and depression measures (for depression only in the face-to-face condition). Face-to-face treatment yielded a statistically larger treatment effect (Cohen d = 0.9) on insomnia severity than the online condition at all time points. In addition, a moderate differential effect size favoring face-to-face treatment emerged at the 3- and 6-mo follow-up on all sleep diary estimates. Face-to-face treatment further outperformed online treatment on depression and anxiety outcomes.
  
  
  CONCLUSIONS
  These data show superior performance of face-to-face treatment relative to online treatment. Yet, our results also suggest that online treatment may offer a potentially cost-effective alternative to and complement face-to-face treatment.
  
  
  BACKGROUND
  Clinicaltrials.gov, NCT01955850.
  
  
  CONCLUSIONS
  A commentary on this article appears in this issue on page 13.
authors.affiliation: Department of Clinical Psychology, University of Amsterdam, the Netherlands.
authors.forename: Jaap
authors.initials: J
authors.lastname: Lancee
authors.affiliation: Department of Clinical Psychology and EMGO Institute, VU University, the Netherlands.
authors.forename: Annemieke
authors.initials: A
authors.lastname: van Straten
authors.affiliation: Department of Clinical Psychology, University of Amsterdam, the Netherlands.
authors.forename: Nexhmedin
authors.initials: N
authors.lastname: Morina
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Sweden.
authors.forename: Viktor
authors.initials: V
authors.lastname: Kaldo
authors.affiliation: Department of Clinical Psychology, University of Amsterdam, the Netherlands.
authors.forename: Jan H
authors.initials: JH
authors.lastname: Kamphuis
mesh_terms: D000328:Adult; D001007:Anxiety; D003071:Cognition; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003194:Computer-Assisted Instruction; D003863:Depression; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D014850:Waiting Lists
keywords: CBT-I; face-to-face; insomnia; internet