Comparing Internet and In-Person Brief Cognitive Behavioral Therapy of Insomnia


Evaluate in-person and Internet-based forms of cognitive behavioral therapy for insomnia with a military population. Determine the benefits of these interventions on improvement in sleep as well as on common co-morbid conditions such as depression, substance abuse, and PTSD symptoms.

The Defense Department is seeking a better way to address the most common complaint of military personnel following deployment to a war zone: insomnia. Daniel Taylor, PhD, of the University of North Texas is working in collaboration with STRONG STAR to try to address it.

Current treatment options

Currently, medications are the most commonly used treatment for insomnia in military populations, and although they can be helpful in the short term, sleep medications also can create problems of their own. Potential side effects such as grogginess, slowed cognitive processing, and slowed reaction time can negatively impact service members’ job performance and even endanger their safety in the war zone, when they may need to awaken quickly or respond immediately to an ambush, mortar or rocket attack, or other emergency situation.

A promising alternative

Dr. Taylor wants to examine the efficacy and feasibility of delivering a form of talk therapy called Cognitive Behavior Therapy for Insomnia (CBTi) to a military population. CBTi is the most effective treatment for insomnia among civilians, with considerably better long-term outcomes than medication — and few if any side effects. New studies show that a more accessible form of this therapy, delivered over the Internet, is also effective with civilians.

Treatment effects may be different in the military, however. On one hand, there are extra treatment challenges, such as erratic military work schedules and the fact that war veterans may associate sleep with combat events, such as nighttime attacks. On the other hand, service members might actually do better with Internet-based treatment than civilians due to the military’s higher literacy rates and the fact that deployed service members have greater access to computers than to behavioral health providers.

The Department of Defense awarded a research grant to Dr. Taylor to investigate these promising therapies, and he has teamed up with the STRONG STAR Multidisciplinary PTSD Research Consortium to achieve his objectives. For his study, he will recruit post-deployment active-duty service members at Fort Hood with chronic insomnia. Participants will receive in-person or Internet-based CBTi during six sessions spread out over six weeks (some will receive treatment at a delayed start date as part of research control measures).

Expected outcomes

Dr. Taylor will evaluate participants’ progress and compare the benefits of these interventions on improvement in sleep as well as on commonly related conditions such as depression, substance abuse, and PTSD symptoms. Ultimately, he aims to provide the military with an evidence-based intervention for deployment-related insomnia with the potential to improve psychological and physical health, decrease accidents, and improve overall war-fighter fitness.

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