Abstract
Background:
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.
Introduction:
This study tests the effectiveness of a Web-based program for insomnia based on principles of CBT and stress management.
Materials and Methods:
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).
Results:
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).
Discussion:
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.
Conclusions:
Go! to Sleep© offers a potentially effective treatment option for adults with insomnia by eliminating geographical barriers to care.
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