How Online Cognitive Behavioural Therapy Can Help People With Insomnia
Insomnia is described as the persistent difficulty initiating and maintaining sleep that is useful present for many years and is thought to effect around 10% of the population with many more suffering a number of the symptoms.
Individuals suffering insomnia are more likely to report a decline in cognitive ability and mood swings due to fatigue and is overall a significant burden on daily lives.
Accessibility of is a common problem in treating many psychological disorders, online cognitive behavioural therapy (OCBT) is increasingly being adopted in order to and increase accessibility and to help more people.
A recent randomised control trial (RCT) published in the Psychological Medicine journal aimed to examine OCBT as an effective treatment for insomnia:
In the current study we examined the effectiveness of an Internet-delivered CBT guided by a personal coach for adults with insomnia using a randomized controlled trial (RCT).
After the recruitment procedure was followed the research team were left with 118 people to take part in the study. The 118 participants were then split into 2 groups:
Half of them (n = 59) were randomized to the guided Internet-based intervention and the other half (n = 59) were randomized to the wait-list control group.
The participants in the experimental group completed a six week internet-based intervention that included the different elements that are commonly incorporated in face-to-face CBT for insomnia:
It is based on a collection of other self-help materials for insomnia, textbooks and research literature. The first version of the intervention was discussed with the co-authors and several other sleep experts.
Participants on the waiting list, control group did not take part in this intervention.
The researchers collected certain information in order to measure the effect the intervention was having:
The patients were asked to complete a sleep diary for 7 days pre- and post-test, and at follow-up for the intervention group. From these diaries we calculated the sleep efficiency (SE), total sleep time (TST), sleep onset latency (SOL) and number of awakenings (NA).
Once the research team had analysed the results they found some interesting findings:
the treatment had significant effects (p < 0.05) on all the remaining sleep estimates (sleep quality, TST, SE, sleeping soundly and feeling refreshed in the morning)
That is to say that those individuals who completed the 6 week online cognitive behavioural therapy course saw the quality, total sleep time, sleep efficiency increase and felt more refreshed in the morning.
The study also found improvement in related problems:
secondary outcomes (symptoms of anxiety and depression, quality of life). The effect sizes were medium to large.
While more research may be needed in order to confirm these findings, these results indicate that this more widely accessible intervention could significantly help individuals suffering from insomnia.
van Straten A, Emmelkamp J, de Wit J, Lancee J, Andersson G, van Someren EJ, & Cuijpers P (2014). Guided Internet-delivered cognitive behavioural treatment for insomnia: a randomized trial. Psychological medicine, 44 (7), 1521-32 PMID: 24001364