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Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science

Specialty

Family Medicine

Advisor

Dr. Thomas Colletti, DHSc, MPAS, PA-C

Abstract

Objective: The purpose of this study is to evaluate evidence for the effectiveness of online cognitive-behavioral therapy for treatment of adult insomnia. Background: Insomnia can adversely affect an individual’s well-being and psychosocial function and, left untreated, can increase the risk of behavioral and physical health deterioration. Cognitive behavioral therapy is now the first-line treatment for reducing symptoms resulting from insomnia.Despite success with traditional face-to-face (FTF) cognitive behavioral therapy for insomnia (CBTi), barriers to treatment, such as lack of trained personnel, equitable access, and cost of services, continue to be problematic. This current study updates the evidence on the effectiveness of online CBTi. Methods: Electronic databases, including EBSCO MEDLINE®, CINAHL®, Ovid MEDLINE®, Ovid EMCARE, PsycINFO®, and PubMed® were searched from database conception to November 2018. Data Extraction: The following data were extracted from studies that met inclusion criteria: pre-post treatment means with standard deviation/standard error, effect sizes, number of participants, control type, dropout rate, duration of treatment, and follow-up timeframe. Results: Twenty studies (N = 7690) met inclusion criteria. Results indicate that online CBTi improves insomnia severity, sleep efficiency, sleep onset latency, total sleep time, wake after sleep onset, and number of nocturnal awakenings with effect sizes (Hedges’s g) -0.75, 0.66, -0.41, 0.21, -0.34, and -0.28, respectively. Conclusion: Evidence supports the effectiveness of online CBT for treatment of chronic insomnia. Online delivered CBTi has the potential to increase access and availability of evidence-based therapy while providing a much needed cost-effective alternative to traditional in-person therapy.

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