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Internet-based treatment for insomnia: a controlled evaluation.

Lars Ström1, Richard Pettersson, Gerhard Andersson

  • 1Department of Psychology, University of Uppsala, Sweden.

Journal of Consulting and Clinical Psychology
|February 6, 2004
PubMed
Summary
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An internet-based cognitive-behavioral self-help treatment for insomnia showed some improvements in sleep, but effect sizes were generally small. The intervention focused on sleep restriction and cognitive restructuring.

Area of Science:

  • Psychology
  • Sleep Medicine
  • Digital Health

Background:

  • Insomnia is a prevalent sleep disorder affecting millions worldwide.
  • Internet-based interventions offer a scalable approach to cognitive behavioral therapy for insomnia (CBT-I).
  • Self-help CBT-I may provide accessible treatment options.

Purpose of the Study:

  • To evaluate the efficacy of a 5-week internet-based cognitive-behavioral self-help intervention for insomnia.
  • To compare treatment outcomes against a waiting list control group.

Main Methods:

  • A randomized controlled trial with 109 participants diagnosed with insomnia.
  • Intervention group received a 5-week internet-based CBT-I (sleep restriction, stimulus control, cognitive restructuring).
  • Sleep diary data collected at baseline and post-treatment; dropout rate was 24%.

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Main Results:

  • Statistically significant improvements observed in the treatment group for total sleep time, wake time in bed, and sleep efficiency.
  • Improvements were also noted in the control group, suggesting potential placebo effects.
  • Between-group effect sizes were generally low, except for the Beliefs and Attitudes About Sleep Scale (Cohen's d =.81).

Conclusions:

  • Internet-based CBT-I demonstrated some positive effects on insomnia symptoms.
  • The study highlights the need for further research into optimizing digital interventions for insomnia.
  • Low effect sizes suggest a need to refine internet-delivered CBT-I for greater clinical impact.