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Efficacy of an Internet-based behavioral intervention for adults with insomnia
A small RCT (22 internet CBT-I vs 23 wait-list controls) reported large Insomnia Severity Index improvements with a structured online program incorporating sleep restriction, stimulus control, hygiene, cognitive restructuring, and relapse prevention, sustained at 6 months.
Design
- RCT; 45 adults randomised (22 internet intervention vs 23 wait-list); 44 analysed (mean age ~45 y)
- Intervention: structured Internet CBT-I (sleep restriction, stimulus control, sleep hygiene, cognitive restructuring, relapse prevention)
- Controls: wait-list
- Outcomes: Insomnia Severity Index (ISI) + sleep diary metrics
Primary published contrasts (ITT)
- ISI: internet group improved from ~15.73 to ~6.59 versus no meaningful change in controls (F(1,42) = 29.64; P < 0.001)
- Durability: internet group maintained gains at 6-month follow-up
Evidence hygiene
- Small n and early-era internet delivery—pair with modern digital CBT-I trials and CBT-I therapist benchmarks.
- Expectancy: wait-list control does not address digital placebo structure; interpret as efficacy vs deferred treatment.
Publication
Ritterband LM, Thorndike FP, Ingersoll KS, et al. Arch Gen Psychiatry. 2009 Jul;66(7):692–698. PMID 19581560.
Outcomes
- Insomnia Severity Index improved from baseline mean ~15.73 (95% CI 14.07–17.39) to ~6.59 (95% CI 4.73–8.45) with internet CBT-I vs no meaningful change in wait-list controls (F(1,42)=29.64; P<0.001).
- Gains on the internet intervention were maintained at the 6-month follow-up per primary publication.