title: "Go! to Sleep": A Web-Based Therapy for Insomnia.
abstract: Insomnia is a common complaint of individuals presenting to healthcare providers and is associated with decreased quality of life and higher healthcare utilization. In-person cognitive behavioral therapy (CBT) is an effective treatment for insomnia but is hindered by cost and limited access to treatment. Initial research suggests that Web-based CBT may mitigate these obstacles.
  
  
  
  This study tests the effectiveness of a Web-based program for insomnia based on principles of CBT and stress management.
  
  
  
  We conducted a randomized trial with wait-list controls among adults with primary insomnia (n = 88). Two hundred sixty-three adults with comorbid insomnia were also included and analyzed separately. The intervention was a 6-week online program, and effectiveness was measured via the Insomnia Severity Index (ISI).
  
  
  
  Baseline ISI score for the intervention group (n = 43) was 17.0; 16.6 for the control group (n = 45). At first follow-up, the intervention group (n = 25) had a mean change from baseline of -7.3 (95% CI: -9.0, -5.6), sustained through second follow-up, while the control group (n = 35) had a change of -1.3 (-2.7, 0.1). The between-group difference was statistically significant (p < 0.001). Participants in the comorbid insomnia group had a baseline ISI score of 16.7 with improvement similar to the primary insomnia group (-6.9; -7.6, -6.2).
  
  
  
  We observed clinically meaningful improvements in insomnia severity in adults with primary or comorbid insomnia. Sustained improvement over 4 months underscores the effectiveness of a well-constructed online CBT for insomnia program.
  
  
  
  Go! to Sleep
authors.affiliation: 1 Wellness Institute , Cleveland Clinic, Lyndhurst, Ohio.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Bernstein
authors.affiliation: 1 Wellness Institute , Cleveland Clinic, Lyndhurst, Ohio.
authors.forename: Didier
authors.initials: D
authors.lastname: Allexandre
authors.affiliation: 2 Quantitative Health Sciences, Cleveland Clinic , Cleveland, Ohio.
authors.forename: James
authors.initials: J
authors.lastname: Bena
authors.affiliation: 1 Wellness Institute , Cleveland Clinic, Lyndhurst, Ohio.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Doyle
authors.affiliation: 1 Wellness Institute , Cleveland Clinic, Lyndhurst, Ohio.
authors.forename: Gina
authors.initials: G
authors.lastname: Gendy
authors.affiliation: 2 Quantitative Health Sciences, Cleveland Clinic , Cleveland, Ohio.
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.affiliation: 1 Wellness Institute , Cleveland Clinic, Lyndhurst, Ohio.
authors.forename: Susan
authors.initials: S
authors.lastname: Fay
authors.affiliation: 3 Sleep Disorders Center, Neurological Institute , Cleveland Clinic, Cleveland, Ohio.
authors.forename: Reena
authors.initials: R
authors.lastname: Mehra
authors.affiliation: 3 Sleep Disorders Center, Neurological Institute , Cleveland Clinic, Cleveland, Ohio.
authors.forename: Douglas
authors.initials: D
authors.lastname: Moul
authors.affiliation: 3 Sleep Disorders Center, Neurological Institute , Cleveland Clinic, Cleveland, Ohio.
authors.forename: Nancy
authors.initials: N
authors.lastname: Foldvary-Schaefer
authors.affiliation: 1 Wellness Institute , Cleveland Clinic, Lyndhurst, Ohio.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Roizen
authors.affiliation: 3 Sleep Disorders Center, Neurological Institute , Cleveland Clinic, Cleveland, Ohio.
authors.forename: Michelle
authors.initials: M
authors.lastname: Drerup
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D007319:Sleep Initiation and Maintenance Disorders / Q000628:therapy*; D017216:Telemedicine / Q000379:methods*; D016896:Treatment Outcome
keywords: cognitive behavioral therapy; insomnia; online; stress; telemedicine