Online Insomnia Program Improves Depression Symptoms

By Amy Orciari Herman

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

A fully automated online intervention can reduce depressive symptoms in adults with insomnia, according to a Lancet Psychiatry study.

Over 1100 adults in Australia who screened positive for insomnia and depressive symptoms (but not major depression) using online tools were randomized to the Internet-based SHUTi program or a control program for 6 weeks. SHUTi used cognitive behavioral therapy and focused on stimulus control, cognitive restructuring, sleep hygiene, and relapse prevention, while the control program simply offered health information.

About half of participants completed follow-up assessments. The primary outcome — change in depressive symptoms from baseline to 6 months — significantly favored the SHUTi group. For SHUTi participants, the mean symptom score fell out of the depressive range. For control participants, however, it remained in the mild depressive range. The intervention also improved secondary outcomes, such as anxiety and suicidal ideation.

Commentators are enthusiastic, writing: "SHUTi (and interventions like it) could potentially become a massive open online intervention, available to anyone in the world with access to the web, at no charge to users or to their country's health-care system. The resulting reduction in human suffering would be hard to match at a similar cost with any existing alternative."