Web- vs. telehealth-based delivery of cognitive behavioral therapy for insomnia: a randomized controlled trial

Sleep Med. 2014 Feb;15(2):187-95. doi: 10.1016/j.sleep.2013.10.013. Epub 2013 Dec 31.


Objectives: The purpose of our study was to evaluate and compare two methods of service delivery (web-based and telehealth-based) for chronic insomnia with regard to patient preference, clinical effectiveness, and patient satisfaction.

Methods: Our study was a randomized controlled trial with manualized telehealth- and web-based delivery conditions (nonblinded). The sample comprised 73 adults with chronic insomnia. Participants received web-based delivery from their homes or telehealth-based delivery from a nearby clinic. Both interventions consisted of identical psychoeducation, sleep hygiene and stimulus control instruction, sleep restriction treatment, relaxation training, cognitive therapy, mindfulness meditation, and medication-tapering assistance.

Results: Using a linear mixed model analysis, results showed that both delivery methods produced equivalent changes in insomnia severity, with large effect sizes. Attendance patterns favored telehealth, whereas homework adherence and preference data favored web-based delivery.

Conclusions: Web- and telehealth-based delivery are both helpful in treating chronic insomnia in rural-dwelling adults.

Keywords: Cognitive behavioral therapy; Insomnia; Online treatment; Rural health; Self-administered treatment; Telehealth.

Publication types

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

MeSH terms

  • Adult
  • Cognitive Behavioral Therapy / methods*
  • Female
  • Humans
  • Internet*
  • Male
  • Patient Compliance
  • Patient Preference
  • Patient Satisfaction
  • Sleep Initiation and Maintenance Disorders / therapy*
  • Social Adjustment
  • Surveys and Questionnaires
  • Telemedicine* / methods
  • Treatment Outcome