Insomnia disorder is highly prevalent in the general population, and a number of epidemiological studies estimate prevalence at 10%–12%.

Defined as difficulty initiating sleep, difficulty maintaining sleep, with subsequent impact upon daytime function, insomnia disorder is associated with daytime fatigue, reduced quality of life, and increased ill health across a range of studies.

Insomnia predicts subsequent depression or anxiety in those with a first episode of mood disorder and is also associated with physical health problems such as hypertension and diabetes.

  • 1998 - 2006

    There is a large body of evidence, based on over 20 years of randomised controlled trials (RCTs), for a specific form of cognitive behavioural therapy (CBT), CBT for insomnia (CBT-i), being an effective and long-lasting treatment for 50%–70% of patients.

  • Psychological and behavioral treatment of insomnia: update of evidence from 1998–2004. Morin et al. 2006

  • 2003 - 2006

    Pharmacological therapies are widely used in primary care, but there is limited evidence for their benefit in chronic insomnia and increasing evidence that these medications are associated with long-term risks, particularly in an older population.

  • Older adults and withdrawal from hypnotics. Curran et al 2003.

    Management of chronic insomnia in elderly persons. Bain KT 2006.

  • 2011 - 2012

    The efficacy of CBT-i to improve outcomes in primary and co-morbid insomnia patients has been repeatedly demonstrated, with improvements in both mental and physical health outcomes.

  • Impact of CBTi on concomitant anxiety. Belleville et al 2011.

    CBT for insomnia co-morbid with COPD. Kapella et al 2011.

    CBT interventions for co-morbid chronic pain & insomnia. Pigeon et al 2012.

  • Internet-based treatment for insomnia: a controlled evaluation. Stroöm et al 2004.

    Efficacy of an Internet-based behavioral intervention for adults with insomnia. Ritterband et al 2009.

    A randomised placebo-control trial of online CBTi. Espie et al 2012.

    Computerised CBTi: a systematic review and meta-analysis. Cheng & Dizon et al 2012.

  • 2004 - 2012

    Several small-cohort studies and two RCTs to date have evaluated online CBT-i and shown promising results but with varying effect sizes.

    CBT-i tackles factors that maintain insomnia over time, including sleep-related dysfunctional cognitions, behaviours which perpetuate insomnia, and dysregulation of the homeostatic sleep drive.

  • 2014

    In the most recent study into the effectiveness of sleepstation, there was a significant increase in sleep efficiency and sleep latency after intervention; with modest improvements in total sleep time. The majority of users reported improved sleep quality. It was concluded that online CBT-i can be designed to deliver personalised therapy with good reported outcomes and high compliance rates in those who start therapy.

  • Online CBTi – targeted screening and interactive web design. Anderson, et al 2014.

  • Treating depression and anxiety with digital CBTi: a real world NHS evaluation using standardized outcome measures. Luik, Bostock, Chisnall & Kyle et al 2016.

    Modified CBTi in depressed adolescents: A pilot study. Conroy & Czopp et al 2017.

    The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis. Freeman, Sheaves, Goodwin et al 2017.

  • 2016 - 2017

    Several RCTs and studies show that understanding and treating disrupted sleep through CBTi could provide a key route to improving mental health.

    In the largest ever RCT of a psychological treatment for mental health, individuals who received online CBTi showed reduction in insomnia as well as improvements in depression, anxiety, and psychological well-being.