Web-based help for insomnia shows promise
(HealthDay)—People find help for all sorts of maladies online. Now, insomnia might be one of them.
A web-based interactive program may help chronically sleepless individuals get needed shuteye without taking medication or spending time on a therapist's couch, a new study suggests.
The six-week program uses cognitive behavior therapy techniques—a standard treatment for insomnia—to help reset sleep patterns, the researchers said.
People who participated in the program "experienced significant and clinically meaningful improvements in their sleep, compared to those who were given online patient education," said lead researcher Lee Ritterband.
Moreover, the results are "similar to outcomes reported in trials that included face-to-face cognitive behavior therapy," said Ritterband. He is a professor at the University of Virginia School of Medicine's department of psychiatry and neurobehavioral sciences.
Ritterband is also a partner in BeHealth Solutions, the company that developed and runs the web-based program, SHUTi (Sleep Healthy Using the Internet).
Insomnia—difficulty falling asleep or staying asleep—is a common problem with medical and psychiatric consequences. As many as half of American adults experience insomnia symptoms, and up to one in five of them actually has an insomnia disorder, according to background notes with the study.
For the study, more than 300 adults were randomly assigned to the six-week program or to online patient education about improving sleep.
Prior to the study, all of the participants regularly needed more than 30 minutes to fall asleep at night, or spent more than 30 minutes of time awake during the night after initially falling asleep.
Program effects were assessed from nine weeks to one year after participation. After one year, seven out of 10 SHUTi participants still showed improvement in their sleep patterns, and 57 percent had no insomnia, the study findings showed.
Dr. Matthew Lorber, director of child and adolescent psychiatry at Lenox Hill Hospital in New York City, pointed out that most physicians treat insomnia with Ambien or other drugs, or recommend cognitive behavior therapy.
"Cognitive behavior therapy is considered a gold standard in dealing with insomnia, but it is expensive," Lorber said. "So if people are able to do this over the internet, that would be fantastic," he added.
It appears that those who are willing to put some work into it could improve their quality of sleep with a program like the one in this study, Lorber concluded.
The SHUTi program costs $135 to $156, according to its website.
Instead of relying on videos or fact sheets, SHUTi actively engages people in behavioral change, the developer says. Participants undergo weekly sessions of about 40 minutes for six weeks and have access to the site for 16 weeks.
The sessions include quizzes, personal stories, homework review and other tasks aimed at improving sleep. Participants are also encouraged to spend two to three minutes a day on an online sleep diary. The program then creates a personal sleep recommendation based on current sleep patterns, the company says.
The intent is to help develop good sleep habits and overcome anxiety related to sleeplessness, the researchers said.
Participants in the study were typical of people in the real world, with about half having other physical or mental health issues in addition to insomnia, Ritterband noted.
"Importantly, people with insomnia and a medical or psychiatric condition still benefited from the automated program," he said.
Lorber said safe programs like this would be a welcome addition to current insomnia treatments.
"Medications are supposed to be short-term interventions, but that's frequently not what happens," Lorber said. "And many of these medications are dangerous and addictive, and it gets to the point where people can't sleep without them."
The report was published online Nov. 30 in the journal JAMA Psychiatry. The study was funded by a grant from the U.S. National Institute of Mental Health.
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