"Go! to Sleep": A Web-Based Therapy for Insomnia

Background: Insomnia is a common complaint of individuals presenting to healthcare providers and is associated with decreased quality of life and higher healthcare utilization. In-person cognitive behavioral therapy (CBT) is an effective treatment for insomnia but is hindered by cost and limited access to treatment. Initial research suggests that Web-based CBT may mitigate these obstacles. Introduction: This study tests the effectiveness of a Web-based program for insomnia based on principles of CBT and stress management. Materials and Methods: We conducted a randomized trial with wait-list controls among adults with primary insomnia (n=88). Two hundred sixty-three adults with comorbid insomnia were also included and analyzed separately. The intervention was a 6-week online program, and effectiveness was measured via the Insomnia Severity Index (ISI). Results: Baseline ISI score for the intervention group (n=43) was 17.0; 16.6 for the control group (n=45). At first follow-up, the intervention group (n=25) had a mean change from baseline of -7.3 (95% CI: -9.0, -5.6), sustained through second follow-up, while the control group (n=35) had a change of -1.3 (-2.7, 0.1). The between-group difference was statistically significant (p<0.001). Participants in the comorbid insomnia group had a baseline ISI score of 16.7 with improvement similar to the primary insomnia group (-6.9; -7.6, -6.2). Discussion: We observed clinically meaningful improvements in insomnia severity in adults with primary or comorbid insomnia. Sustained improvement over 4 months underscores the effectiveness of a well-constructed online CBT for insomnia program. Conclusions: Go! to Sleep (c) offers a potentially effective treatment option for adults with insomnia by eliminating geographical barriers to care.