July 08, 2009
Internet-Based Intervention for Insomnia
Another study of online CBT for insomnia published in this month's Archives of General Psychiatry shows promise. Researchers from the University of Virginia Health System conducted a study of an Internet based intervention program designed to treat insomnia. The online program based on established face-to-face cognitive behavioral therapy techniques is called SHUTi (Sleep Healthy Using the Internet).
44 adults (average age 44.9) who had a history of sleep difficulties lasting longer than 10 years on average were recruited through newspaper advertisements, online postings, radio broadcasts, public service announcements, flyers, and physician referrals. Interested individuals were screened sequentially through an online interest form, a 15-minute telephone screen, and an in-person semistructured interview. Participants also completed questionnaires to further assess sleep behaviors and psychological functioning. After initial assessment, participants were taught how to complete sleep diaries and navigate the online program. To protect confidentiality, participants were assigned unique user names and passwords for purposes of log-in. A total of 22 participants were randomly assigned to a control group and 22 received the Internet intervention.
The highly interactive nine-week program uses text, graphics, animations, vignettes, quizzes and games to present behavioral, educational and cognitive techniques for improving sleep. For instance, patients were 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.
Participants completed daily sleep diaries before and after the intervention and also rated their symptoms on the seven-item Insomnia Severity Index, which produces a score from zero (no symptoms) to 28 (severe insomnia). Among individuals who received the intervention, scores on the index improved from 15.73 to 6.59, whereas scores did not change for the control group. These gains were maintained at a six-month follow-up assessment.
According to the researchers, "an Internet intervention has the potential of meeting the large unmet treatment need of the population with insomnia by providing effective treatment through the Web.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."
Arch Gen Psychiatry. 2009;66(7):692-698.
Medgadget story (with video interview of researcher)
Posted by rsk at July 8, 2009 11:19 AM