Logging on for better sleep: RCT of the effectiveness of online treatment for insomnia

Sleep. 2009 Jun;32(6):807-15. doi: 10.1093/sleep/32.6.807.


Study objectives: Despite effective cognitive behavioral treatments for chronic insomnia, such treatments are underutilized. This study evaluated the impact of a 5-week, online treatment for insomnia.

Design: This was a randomized controlled trial with online treatment and waiting list control conditions.

Participants: Participants were 118 adults with chronic insomnia.

Setting: Participants received online treatment from their homes.

Intervention: Online treatment consisted of psychoeducation, sleep hygiene, and stimulus control instruction, sleep restriction treatment, relaxation training, cognitive therapy, and help with medication tapering.

Measurement and results: From pre- to post-treatment, there was a 33% attrition rate, and attrition was related to referral status (i.e., dropouts were more likely to have been referred for treatment rather than recruited from the community). Using a mixed model analysis of variance procedure (ANOVA), results showed that online treatment produced statistically significant improvements in the primary end points of sleep quality, insomnia severity, and daytime fatigue. Online treatment also produced significant changes in process variables of pre-sleep cognitive arousal and dysfunctional beliefs about sleep.

Conclusions: Implications of these findings are that identification of who most benefits from online treatment is a worthy area of future study.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Circadian Rhythm
  • Cognitive Behavioral Therapy / methods*
  • Combined Modality Therapy
  • Comorbidity
  • Female
  • Follow-Up Studies
  • Health Behavior
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Internet*
  • Male
  • Middle Aged
  • Patient Education as Topic / methods
  • Relaxation Therapy
  • Sleep Initiation and Maintenance Disorders / diagnosis
  • Sleep Initiation and Maintenance Disorders / psychology
  • Sleep Initiation and Maintenance Disorders / therapy*
  • Therapy, Computer-Assisted*


  • Hypnotics and Sedatives