Approximately 500 000 Norwegians suffer from chronic sleep disorders, also called insomnia. Researchers have long known that cognitive behavioural therapy for insomnia is the best documented treatment, but few people have access to such therapy.
A fully automated digital version of this treatment has proven effective for many patients and can reduce the use of sleeping pills.
"Our results show that it's possible to provide very effective and drug-free sleep treatment on a large scale. This can be done without meeting with health personnel," says clinical psychologist Håvard Kallestad.
Kallestad is a researcher at St. Olav's Hospital and at the Norwegian University of Science and Technology's (NTNU) Department of Mental Health. He is also one of the first authors of a newly published article in The Lancet Digital Health.
Digital sleep support can help people identify the underlying causes of their sleep issues. The treatment addresses problematic sleep patterns, various stressors and other factors that interfere with sleep. Patients keep a journal that can provide insight into their own situation.
The new study in The Lancet Digital Health is encouraging.
The treatment study included 1721 participants, who received either digital sleep therapy or good sleep advice and digital information about sleep problems. All were Norwegian adults over the age of 18 who had difficulty sleeping. The findings are quite clear.
Approximately six of ten participants (58 per cent) experienced substantial improvement from the digital sleep therapy. In the control group, which received good sleep advice and digital information, only around 20 per cent experienced a similar effect. The digital sleep treatment was thus about three times as effective.
Thirty-eight per cent of participants achieved normal sleep quality after undergoing the digital sleep therapy. Only eight per cent of the control group had similar results.
"We also found that the participants who received digital sleep treatment were able to reduce their use of sleeping pills more than participants who only received sleep advice," says Kallestad.
This form of psychological therapy for a significant public health problem could prove to be more accessible than sleep medication treatment.
Digital sleep therapy is fully automated, meaning that no appointment with a health care provider is needed for the treatment. The study interventions were also automated.
The sleep treatment takes about 6 to 8 weeks to complete.
The study is a collaborative project between the Norwegian Institute of Public Health, NTNU and St. Olavs Hospital. It is funded by the Research Council of Norway (FHI) and Samarbeidsorganet (The Liaison Committee for Education, Research and Innovation in Central Norway) between the Central Norway Regional Health Authority and NTNU.
Researcher Øystein Vedaa from FHI and NTNU and Kallestad shared first authorship in this study. Børge Sivertsen from FHI and NTNU was the last author. The digital sleep therapy programme used in the study was developed at the University of Virginia.
Source: Lancet Digital Health. Effects of digital cognitive behavioural therapy for insomnia on insomnia severity: a large-scale randomised controlled trial. Øystein Vedaa, Håvard Kallestad, Jan Scott, Otto R.F. Smith, Ståle Pallesen, Gunnar Morken, Knut Langsrud, Philip Gehrman, Frances P Thorndike, Lee M. Ritterband, Allison G. Harvey, Tore Stiles, Børge Sivertsen.
The Lancet Digital Health