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Internet, in-person cognitive behavioral therapy effective for insomnia in military

Cognitive behavioral therapy for insomnia delivered in person or via the internet improved insomnia among military personnel.

“About 10% of deployed military personnel take sleep medications, which are effective for short-term treatment of insomnia in civilian populations. For deployed military personnel, the side effects such as grogginess, slowed cognitive processing and slowed reaction time can be dangerous,” Daniel J. Taylor, PhD, of the University of North Texas, Denton, Texas, said in a press release.

To determine efficacy of in-person and unguided CBT for insomnia in military personnel, researchers conducted a three-arm parallel randomized clinical trial among 100 active duty U.S. Army personnel at Ford Hood, Texas. Study participants were randomly assigned to receive in-person or internet CBT for insomnia or a minimal contact control condition, which consisted of phone call assessments.

Internet and in-person CBT for insomnia significantly improved reported sleep efficiency (d = 0.89; 0.53), sleep onset latency (d = 0.68; 0.53), number of awakenings (d = 0.42; 0.54), wake time after sleep onset (d = 0.88; 0.5), Insomnia Severity index and Dysfunctional Beliefs (d = 0.98; 0.51) and Attitudes About Sleep Scale scores (d = –1.12; –0.54).

Improvements in self-reported sleep quality (d = 0.8) and dysfunctional beliefs and attitudes about sleep (d = –0.58) were greater among participants who received in-person treatment.

Self-reported daytime sleepiness and actigraphy-assessed sleep parameters did not differ.

Technical difficulties with internet treatment prevented tailored sleep restriction upward titration for some participants, according to researchers.

“The online program can also be done from home rather than at a military behavioral health clinic, which some service members may avoid due to concerns about stigma,” study researcher Kristi E. Pruiksma, PhD, of University of Texas Health Science Center at San Antonio, said in the release. “Successful treatment has a real impact on patients’ daily lives. An important next step will be to figure out who is able to achieve good benefits from the online program and who is likely to need additional assistance from a therapist.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.