This post presents mounting evidence that internet-based therapy for insomnia can be very successful at improving sleep onset, duration and quality, followed by two resources that you can use now if you would like to try it. I’ll start with a study published not long ago in the journal Archives of General Psychiatry that begins with the observation that “Insomnia is a major health problem with significant psychological, health, and economic consequences. However, availability of one of the most effective insomnia treatments, cognitive behavioral therapy, is significantly limited.” The authors then set out to “evaluate the efficacy of a structured behavioral Internet intervention for adults with insomnia.” Their welcome conclusion: “Participants who received the Internet intervention for insomnia significantly improved their sleep, whereas the control group did not have a significant change. The Internet appears to have considerable potential in delivering a structured behavioral program for insomnia.” (For the record, they just published a correction of “2 minor computation errors” that “do not substantively change any of the results and do not alter any conclusions reached about the impact of the Internet intervention on sleep.”)

Another study appeared last summer in the journal Sleep that “evaluated the impact of a 5-week, online treatment for insomnia.” The participants were 118 adults suffering from chronic insomnia who received online treatment from their homes. The authors reported “results showed that online treatment produced statistically significant improvements in the primary end points of sleep quality, insomnia severity, and daytime fatigue,” but also observed that motivation of the participants was a factor (naturally).

These studies added to an earlier paper published in the Journal of Consulting and Clinical Psychology that randomly assigned 108 subjects “to either a cognitive-behavioral self-help treatment [internet-based] or a waiting list control condition.” The authors stated that “Results showed statistically significant improvements in the treatment group on many outcome measures, including total sleep time, total wake time in bed, and sleep efficiency,” but also noted that “improvements were also found in the control group. Overall, between-groups effect sizes were low, with the exception of the Beliefs and Attitudes About Sleep Scale.”

One more paper for your consideration was published in the Journal of Occupational Health a while back. It evaluated the effectiveness of an intervention program that lasted for only 2 weeks. The authors stated these findings and conclusion: “The sleep quality score increased in the intervention group at post-intervention… Sleep-related behaviors also greatly increased in the intervention group at post-intervention… Sleep-onset latency reduced in the intervention group at follow-up, with a marginally significant effect. The Internet-based self-help program improves subjective sleep quality and sleep-onset latency among adult workers.”

There is a caveat here. As you can see from these studies, internet-based CBT (cognitive-behavioral therapy) can be very helpful for insomnia. However, the biological component can be very significant and, in many cases, decisive. And as you know, the common medications have serious side-effects. It makes sense that the ideal program combines a functional medicine approach to any underlying neurological, endocrine and metabolic factors with the behavioral modifications of CBT. For those who would like to try an internet-based CBT program for insomnia, two resources presently available are CBTforInsomnia.com and HealthMedia Overcoming Insomnia (I have no affiliation with either.)

-