2013/09/04 by A. van Straten, Annemieke van Straten, J Emmelkamp +10 · 134 citations
Medicine · Neuroscience · Psychology · #Anxiety #Cognitive behavioral therapy #Cognitive behavioral therapy for insomnia #Digital Mental Health Interventions #Insomnia #Internal medicine #Intervention (counseling) #Medicine #Physical therapy #Population #Psychiatry #Quality of life (healthcare) #Randomized controlled trial #Sleep and Wakefulness Research #Sleep and related disorders #Sleep onset #Sleep onset latency
paper · open access · doi:10.1017/s0033291713002249
published in Psychological Medicine 44(7), 1521-1532 (Cambridge University Press)
openalex publication_date 2013/09/04 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/03
BACKGROUND: Insomnia is a prevalent problem with a high burden of disease (e.g. reduced quality of life, reduced work capacity) and a high co-morbidity with other mental and somatic disorders. Cognitive behavioural therapy (CBT) is effective in the treatment of insomnia but is seldom offered. CBT delivered through the Internet might be a more accessible alternative. In this study we examined the effectiveness of a guided Internet-delivered CBT for adults with insomnia using a randomized controlled trial (RCT). METHOD: A total of 118 patients, recruited from the general population, were randomized to the 6-week guided Internet intervention (n = 59) or to a wait-list control group (n = 59). Patients filled out an online questionnaire and a 7-day sleep diary before (T0) and after (T1) the 6-week period. The intervention group received a follow-up questionnaire 3 months after baseline (T2). RESULTS: Almost three-quarters (72.9%) of the patients completed the whole intervention. Intention-to-treat (ITT) analysis showed that the treatment had statistically significant medium to large effects (p < 0.05; Cohen's d between 0.40 and 1.06), and resulted more often in clinically relevant changes, on all sleep and secondary outcomes with the exception of sleep onset latency (SOL) and number of awakenings (NA). There was a non-significant difference in the reduction in sleep medication between the intervention (a decrease of 6.8%) and control (an increase of 1.8%) groups (p = 0.20). Data on longer-term effects were inconclusive. CONCLUSIONS: This study adds to the growing body of literature that indicates that guided CBT for insomnia can be delivered through the Internet. Patients accept the format and their sleep improves.