Behavioral Intervention Helps Insomnia Patients Sleep Better

An innovative Internet-based intervention based on well-established face-to-face cognitive behavioral therapy techniques is improving insomnia patients' sleep.

Researchers at the University of Virginia Health System (UVA, Charlottesville, USA) evaluated the effectiveness of the Internet intervention among 45 adults who had a history of sleep difficulties lasting more than 10 years on average. Twenty-two of the participants were randomly assigned to receive the Internet intervention called SHUTi. The remaining twenty-three acted as controls. The interactive nine-week program uses text, graphics, animations, vignettes, quizzes, and games to present behavioral, educational, and cognitive techniques for improving sleep. The participants completed daily sleep diaries before and after the intervention, and rated their symptoms on the seven-item, 28-point Insomnia Severity Index (ISI).

The researchers found that after completing the study, 73% of the patients who used the SHUTi system reported no severity of insomnia, and in fact reported ISI scores that improved from 15.73 to 6.59; these gains were maintained at a six-month follow-up assessment. The control patients, on the other hand, continued to show the same level of moderate severity. The study was published in the July 2009 issue of Archives of General Psychiatry.

"An Internet intervention has the potential of meeting the large unmet treatment needs of the population with insomnia by providing effective treatment through the Web,” said lead author Lee Ritterband, Ph.D., an associate professor of psychiatry and neurobehavioral sciences at UVA. "An effective and inexpensive Internet intervention would expand treatment options for large numbers of adults with insomnia, especially those whose geographical location prohibits access to relevant care, and could be a substantive first-line treatment choice.”

Cognitive behavioral therapy is a psychological treatment focusing on the behaviors and dysfunctional thoughts that contribute to sleep problems, and is one of the most effective treatments for insomnia. For instance, patients are advised to avoid reading and watching television in the bedroom, stop daytime napping, and change unhelpful beliefs and thoughts (including worries about the consequences of insomnia) that may exacerbate sleep difficulties.

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