A randomized controlled trial of an internet intervention for adults with insomnia: effects on comorbid psychological and fatigue symptoms

J Clin Psychol. 2013 Oct;69(10):1078-93. doi: 10.1002/jclp.22032. Epub 2013 Aug 28.


Objective: Insomnia is frequently comorbid with other medical and psychological disorders. This secondary data analysis investigated whether an Internet-delivered cognitive behavioral therapy for insomnia (CBT-I) intervention could also reduce comorbid psychological and fatigue symptoms.

Method: Data from a pilot randomized controlled trial (RCT) testing the efficacy of Internet-delivered CBT-I relative to a waitlist control was used to examine changes in symptoms of depression, anxiety, mental health quality of life (QOL), and fatigue.

Results: Group by time interactions from repeated measures analyses revealed significant post intervention improvements in Internet participants (n = 22) relative to control participants (n = 22) on all psychological symptoms, mental health QOL, and fatigue. A small post hoc subsample of Internet participants with mild or moderate depression also showed large effect size changes in these constructs (depression, anxiety, mental health QOL, and fatigue).

Conclusion: Internet-delivered CBT-I appears to not only improve sleep but also reduce comorbid psychological and fatigue symptoms.

Keywords: CBT; CBT-I; Internet; anxiety; cognitive behavioral therapy; depression; eHealth; fatigue; insomnia; online; web.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anxiety / epidemiology
  • Anxiety / therapy
  • Cognitive Behavioral Therapy / methods*
  • Comorbidity
  • Depression / epidemiology
  • Depression / therapy
  • Fatigue / epidemiology
  • Fatigue / therapy*
  • Female
  • Humans
  • Internet / statistics & numerical data
  • Male
  • Mental Disorders / epidemiology
  • Mental Disorders / therapy*
  • Middle Aged
  • Quality of Life / psychology
  • Sleep Initiation and Maintenance Disorders / epidemiology
  • Sleep Initiation and Maintenance Disorders / therapy*
  • Telemedicine / methods*
  • Treatment Outcome