Insomnia is one of the most common disorders. Depending on the data, even 30% of people with this condition are affected.
The reasons are different. They include, for example, stress through circulatory, respiratory, trauma, eating problems, and simply incorrect sleep hygiene, by which we mean a general set of factors that are not conducive to successful sleep, such as too much blue light being emitted by electronic devices before the planned sleep. Sometimes sleep disorders are short-term and occasional and the body makes up for the lack of sleep quite quickly. If they are notorious, we can talk about typical insomnia, which should lead us to look for a solution to the problem. Given that sleep significantly affects the condition of the body it should not be underestimated.
TREATMENT DURING CORONAVIRUS PANDEMIC
Due to the SARS-CoV-2 virus pandemic and restrictions that apply almost worldwide, access to specialists is significantly restricted. Not long ago, it seemed that the use of remote treatment and diagnosis of diseases was the melody of the future. Given that the restrictions are still in place and that we are uncertain as to their scope in the coming months, and given the limited access to specialists even without restrictions, it is worthwhile using the technology where possible.
EDUCATION AND FAST RESPONSE
As with every disorder and every disease, it is important to be aware of the problem and have access to reliable knowledge of the possible causes, in this case, insomnia, as well as the steps to take. In the era of universal access to information, the Internet offers many possibilities. Usually, it is worthwhile to implement healthy habits in this area in the first place, waiting for a possible visit to a specialist in the treatment of sleep disorders.
Cognitive-behavioral therapy (CBT – cognitive-behavioral therapy) is the most commonly recommended treatment for insomnia. The SHUTi method (Sleep Healthy Using the Internet) has been available for several years. This is Internet cognitive-behavioral therapy (CBT-I). It allows the same treatment as that received from a qualified specialist in CBT therapy.
In 2012, a program was designed for people who have suffered from cancer, because insomnia affects them very often. The program was divided into 6 interactive stages, lasting 6-9 weeks. Each of the stages took 45-60 minutes.
- Stage 1:stage was aimed at acquiring theoretical knowledge about insomnia, i.e. its definition, influence, and risk factors associated with it, as well as an introduction to the method.
- Stage 2: was focused on limiting the factors preventing sleep.
- Stage 3: this is where the practices and control of stimuli in the previous stage were strengthened.
- Stage 4:continuation of education, but in this case good sleep-enhancing practices such as increasing daily physical exercise were presented to participants.
- Stage 5: its aim was to solve and change unfavorable beliefs and thoughts about sleep, mainly in order not to worry about the consequences of insufficient sleep, while less could be enough.
- End-stage 6: finally, attention is paid to preventing problems and promoting adherence to developed habits, and identifying potential risk situations to prevent recurrence of insomnia.
The participants received on-line reminders, filled in their dream diaries, thanks to which the program algorithm adjusted the therapy to the patient’s needs.
The above study concerned a modest, because a 28-person control group, which gave high measurement uncertainty. The largest study of the effectiveness of this method took place in 2016-2018 and was conducted on a group of 1721 Norwegians. The Norwegian fully automated therapy (dCDT-I), similar to the SHUTi method, gave satisfactory results. Approximately 58% of participants declared a significant improvement in sleep quality. As in every decent study, a control group was used, which was only given good sleep advice. In this group only 20% indicated improvement.
The expected results, i.e. normal amount and quality of sleep, were observed in 38% of the subjects in whom digital sleep therapy was implemented, while in the second group this percentage was only 8%.
Depending on the causes of insomnia, drugs may be necessary. A specialist should be consulted. Nevertheless, every drug contains an extensive list of possible side effects. This is why the presented studies give hope for a reduction in pharmacotherapy because participants of interactive therapy used sleeping pills less often.
ON-LINE VS. DIRECT THERAPY
The study did not provide knowledge comparing the effectiveness of stationary behavioral-cognitive therapy with fully automated online therapy. Regardless of the differences, given the universal access to the Internet, online therapy (CBT-I) can increase access to professional help in insomnia treatment. It is important that such therapy is developed by specialists in behavioral and cognitive therapy.
In any case, it may be necessary to seek advice from a specialist, which should be kept in mind. Internet knowledge, also on this blog, is not a substitute for professional advice but is only meant to help you find a solution to your problem.
- Ritterband LM, Bailey ET, Thorndike FP, Lord HR, Farrell-Carnahan L, Baum LD. Initial evaluation of an Internet intervention to improve the sleep of cancer survivors with insomnia. Psychooncology. 2012;21(7):695-705. doi:10.1002/pon.1969
- Vedaa Ø., Kallestad H., Scott J., et. al, Effects of digital cognitive behavioural therapy for insomnia on insomnia severity: a large-scale randomised controlled trial. Lancet Digital Health. 2020; 2: e397-e406. doi.org/10.1016/S2589-7500(20)30135-7