Nearly 75 percent of American adults experience sleeps disorder symptoms at least a few nights per week. Insomnia is the most common sleep disorder, affecting between 10 and 20 percent of the population. 

The combination of insomnia care, medications, sleep-aids and loss of work productivity costs the United States about $5.3 billion. Unfortunately for the individual and the country, the majority of people suffering from chronic insomnia go untreated. Inaccessibility to cognitive-behavioral treatment of insomnia (CBT-I) is a major issue.

Millennial solutions

Web-based self-help programs are an innovative solution for treating a large population with chronic insomnia in a cost-effective way.

The National Sleep Foundation recommends between seven and nine hours of sleep for adults and between seven and eight for older adults ages 65 and over, but 20 percent of Americans report getting less than six hours of sleep on average.

"Getting less than six hours of sleep affects nearly every organ system decreasing glucose tolerance, increasing risk for obesity, increasing inflammation, and causing mental health and heart issues."

Getting less than six hours of sleep affects nearly every organ system decreasing glucose tolerance, increasing risk for obesity, increasing inflammation and causing mental health and heart issues.

CBT-I has historically been delivered to patients through face-to-face appointments with behavioral sleep medicine specialists or psychologists. A patient usually sees a therapist four to eight times for about an hour each. Most clinical models combine multiple treatment options including behavioral strategies like stimulus control and sleep restriction, education on good sleeping habits and relaxation therapies, among others. 

Traditional CBT-I is effective for insomnia, and according to research, the benefits outlast prescription drugs despite the popularity of prescribing them for treatment.

The number of trained specialists needed to replace the drugs prescribed for millions of Americans, though, is inconceivable.

Working through restlessness

Several recent studies have supported the benefit of web-based versions of CBT-I, like Cleveland Clinic’s Go! to Sleep (GTS) program. ‘Go! to Sleep’ is a 6-week online course for improving sleep and insomnia symptoms, teaches you to identify and then reframe specific thoughts and behaviors that are interfering with your ability to sleep deeply - all in the comfort and privacy of your own bedroom. The internet sessions have been based on well-established face-to-face cognitive behavioral therapy. Patients pay a nominal fee of $40, and log-on from a convenient location on their own desktop. The web-based program is also available in the form of an iPhone app.    

Collaborative research between the Cleveland Clinic Sleep Disorders Center and Wellness Institute found that after six weeks of web-based therapy using GTS, participants reported fewer insomnia symptoms and reduced stress levels as compared to those in the study who simply waited for their symptoms to improve.