Getting Your Zzzzs, Online

New Web site offers six-week insomnia therapy, but not all users may benefit

FRIDAY, Sept. 9, 2005 (HealthDay News) -- Millions of tossing and turning Americans could find relief for their insomnia from a new six-week behavioral therapy program, available online.

The therapy -- which costs users a total of $35 -- is the brainchild of Gregg Jacobs, an insomnia specialist at the Sleep Disorders Center of Beth Israel Deaconess Medical Center, Boston, and an assistant professor of psychiatry at Harvard Medical School.

"Insomnia, to a large extent, is a learned problem," Jacobs explained. "It is due to the way people think about their sleep and their sleep behaviors. These actually cause the insomnia, but they can be changed to eliminate the insomnia."

But another therapist cautioned that a Web-based program may not send all insomniac users into peaceful slumber.

Joyce Walsleben, past director of the New York University Sleep Disorders Center, said, "I think it's a great idea," but added that "people are so individual -- there is a cluster who will like that, [and] there's a cluster who couldn't do it."

About 60 million Americans a year have insomnia often or for extended periods, according to the National Institute of Neurological Disorders and Stroke. Untreated chronic insomnia can lead to even more serious sleep deficits.

Although pills can help people sleep, they are no cure for insomnia, Jacobs said. Citing the National Institutes of Health, he said a consensus panel of experts there endorsed cognitive behavioral therapy as being more effective, and the preferred treatment for chronic insomnia over sleeping pills.

Cognitive behavioral therapy teaches poor sleepers how to modify stressful thought about their sleep, modify negative or disruptive sleep behaviors, improve relaxation skills and improve lifestyle practices, Jacobs said. "Remarkably, this can be done in a short period of time," he added. The method works with up to 75 percent of patients, Jacobs noted.

The problem with cognitive behavioral therapy is that few have access to it, Jacobs said. "There are only 200 clinicians worldwide who have extensive experience in this area," he said. "Most sleep clinics don't offer it."

"I realized that it would never become widely available unless we made it available on the Internet," Jacobs said.

The program offered on the Web site is the same program that Jacobs tested in an NIH-funded study. That study showed that a cognitive behavioral therapy program was more effective than Ambien, the leading sleep medication.

Jacobs has translated that program to the Web. "We took the exact same program and put it into an interactive, dynamic format. The program allows patients to do things they can't do with a therapist," he said.

Unlike seeing a therapist, a user can visit the program every day for progress updates and reinforcement. The program consists of six modules that are designed to be completed in six half-hour sessions conducted over six weeks.

"The program calculates your sleep pattern," Jacobs explained. "It gives you immediate feedback not only on your sleep pattern, but also prescribes very specific goals to follow involving cognitive and behavioral techniques. The program identifies when you are not inline with those goals and provides suggestion in how to accomplish those goals."

The program can be accessed at http://www.cbtforinsomnia.com/.

"My belief is this is a more effective way to treat patients with insomnia," Jacobs said. "This will not only revolutionize the way cognitive behavioral therapy is made available, but it will also revolutionize the treatment of insomnia."

Walsleben agreed that cognitive behavioral therapy, sometimes aided (at least initially) by sleeping pills, is the best way to cure insomnia.

But she said she has doubts about whether a computer program will help everyone with the problem.

"Clearly, this could work for people who are good with the Internet," she said. But she believes others will need "a lot of hands-on verbalizing [with a therapist]. I like that person-to-person touch."

More information

The National Sleep Foundation can tell you more about insomnia.

SOURCES: Gregg Jacobs, Ph.D., insomnia specialist, Sleep Disorders Center of Beth Israel Deaconess Medical Center, and assistant professor, psychiatry, Harvard Medical School, Boston; Joyce Walsleben, Ph.D., past director, New York University Sleep Disorders Center, New York City
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