Online Treatment of Insomnia
The first controlled study of an online program for insomnia was published in 2004. But the results were hard to interpret, because they showed similar benefits for those who used the program and those in the control group. The two new studies, from researchers in Virginia and in Canada, advance the evidence that such programs can work.
In the Virginia study, called SHUTi, patients enter several weeks of sleep diaries, and the program calculates a window of time during which they are allowed to sleep. Patients limit the time they spend in bed to roughly the hours that they have actually been sleeping. The SHUTi program, which spans nine weeks, advises patients to get out of bed if they wake and are unable to return to sleep for more than 15 minutes. It also uses readings, vignettes, animation and interactive exercises to help patients deal with factors that interfere with sleep. For example, the program helps patients manage anxious thoughts, like the idea that they cannot function without eight solid hours of sleep. It also reinforces the message that they should not do work or watch TV in bed, should limit the light in the bedroom and should avoid stimulants like caffeine late in the day. “The outcomes were very impressive, almost unbelievable,” said Jack Edinger, a psychologist at Duke University Medical Center.
The Canadian study tested a five-week program that also emphasized sleep restriction, controlling negative thoughts and avoiding stimuli like light and noise in the bedroom. It also included readings, and audio and video clips to teach and reinforce its messages.
Led by Norah Vincent, a psychologist at the University of Manitoba, the study included 118 adults who were randomly assigned to complete the program or remain on a waiting list.
“I liked that it was over the Internet,” said one participant, Kelly Lawrence, 51, of Winnipeg, “because when you don’t get your sleep you don’t want to have to get up and go to appointments. You don’t want to be out there on the roads.”
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