CBT - Online Therapy To Fight Insomnia

By Margarita Nahapetyan

A recent scientific study has recently proven the effectiveness of an online cognitive behavioral therapy (CBT) on fighting insomnia. The new findings demonstrate that CBT significantly improves insomnia severity, daytime fatigue, and the quality of sleep.

The investigators at the University of Manitoba in Winnipeg, Canada, have found that 81 per cent of participants who used CBT (30 of 37) showed at least mild improvement in their sleep after completing the 5-week program. This included 35 per cent (13 of 37) of those who reported significant improvement. At the end of the program, 30 per cent of individuals who were enrolled in the program said that they were receiving an additional hour of sleep. Those who received the therapy also were more likely to develop healthier attitudes about sleep and were less likely to report having an overactive mind at bedtime.

For the study purposes, the investigators recruited 118 adults who suffered chronic insomnia. Some individuals were referred to a teaching hospital behavioral medicine sleep clinic and others had responded to a newspaper ad. The requirement of the experts was that all the participants in the study had to have a computer at home and an access to a high-speed Internet. In addition, they needed to have an insomnia complaint with consequences such as daytime impairment occurring more than four nights on a weekly basis for the period of half a year or longer.

At the beginning of the study, the subjects were randomly assigned to two different groups: a treatment group or a wait list group. Participants in the wait list group were told that they would have access to the therapy as soon as their follow-up information was received, and they were asked not to seek treatment during the course of the study. Participants who were assigned to the treatment group, engaged in online cognitive behavioral therapy from home for the period of 5 weeks with no clinician interaction.

Based on CBT techniques, the virtual therapy consisted of a combination of videos, text and audio clips to teach the sufferers everything about good sleep hygiene, from how to relax the body before getting into bed to how not to panic when they failed to fall asleep right away. CBT subjects were asked to keep digital sleep diaries and practice the techniques that were shown on the computer screen. Audiovisual clips were used as the main teaching component, as well as downloadable mp3 files for relaxation practicing. The participants were also downloading audio clips of a sleep therapist and an actor in a staged face-to-face session and were listening to them on their iPods.

Dr. Norah Vincent, PhD, psychologist at the University of Manitoba, and the principal investigator of the research team that conducted the study, said that the scientists were amazed to find that the participants demonstrated such good improvements without help from professionals, and without seeing a clinician, or taking medication, in order to address their problem.

In spite of the fact that each segment of the CBT program is important, the cognitive therapy module was the most positively rated, said Dr. Vincent and added that "The cognitive therapy section was designed to help individuals to develop realistic expectations about sleep and the impact of sleep on next-day functioning while teaching a variety of strategies for coping with an overactive mind and worries." The expert said that most individuals could potentially benefit from online cognitive behavioral therapy for persistent, or chronic insomnia, as the program has been used successfully by individuals with the ages between 18 and 80 years. The researchers assume that the program could also be of a big help for teenagers.

The findings are published in the June 1 issue of the journal SLEEP.