Online Therapy Can Help Insomniacs Finally Get Some Sleep
By Shelby Lorman
Insomniacs rejoice! There might actually be a treatment for your sleeplessness that doesn’t require a pill.
A recent study published in the journal JAMA Psychiatry found that online, web-based CBT-I (cognitive behavioral therapy for insomnia) can be an effective, medication-free method of treating chronic insomnia.
CBT-I encourages people to change their habits, not pop a pill. CBT-I helps insomniacs identify harmful habits, and teaches them how to create conditions more conducive to good sleep, creating potentially lasting behaviors without the side effects.
Defined by the CDC as an inability to “initiate or maintain sleep,” insomnia impacts millions of adults and has detrimental effects beyond the bedroom, often resulting in “functional impairment throughout the day.”
Led by researchers at the University of Virginia, the study was designed to address the effectiveness of CBT-I — described as what should be the “the first line recommendation” for those suffering chronic insomnia. The study, a randomized clinical trial of 303 adults with chronic insomnia, introduced half of this group to an online educational program that provided “fixed information about insomnia,” while the other half participated in the 6-week online CBT-I program called SHUTi (Sleep Healthy Using the Internet). Participants were followed up with after 9 weeks, 6 months and 1 year.
People reported improvement within a few weeks, and a year later, the study shows that 56.6% had achieved insomnia “remission status” and 69.7% responded to treatment.
Dr. Gregg Jacobs, creator of the first drug-free program for treating chronic insomnia and founder of CBT for Insomnia, describes how insomnia impacts people in Arianna Huffington’s book The Sleep Revolution: “After a few weeks of lying awake at night, frustrated and anxious about insomnia…people start to anticipate not sleeping and become apprehensive about going to bed. They soon learn to associate the bed with sleeplessness and frustration; consequently, the bed quickly becomes a learned cue for wakefulness and insomnia.”
Jacobs created his own virtual CBT treatment in 2005, a 5-week, 5-session online program based on his 25 years of research and clinical practice at the Harvard Medical School, and work with over 10,000 insomnia patients at the University of Massachusetts Memorial Medical Center. Jacobs’ own findings show that after participating in CBT-I, “more than 75 percent of insomnia patients experienced sleep improvements” and “90 percent stopped or reduced their use of sleeping pills.”
One of the main draws of the JAMA study and Jacobs’ work is that it supports CBT-I as the most effective treatment option, which could reduce dependency on sleeping pills. Jacobs writes that, “sleeping pills do not generally improve sleep,” and that “newer-generation sleeping pills such as Ambien are no more effective than a placebo.” Sleeping pills also have detrimental side effects, especially for those over 60 years old. Side effects include “impaired learning and memory, daytime sedation” and increased risk of overdose, dependency and depression.