The DOI matches its Crossref record; 54 of the 54 references it cites were found in a registry or an index.
Efficacy of an Internet-Based Behavioral Intervention for Adults With Insomnia
Open accessAbstract
CONTEXT: Insomnia is a major health problem with significant psychological, health, and economic consequences. However, availability of one of the most effective insomnia treatments, cognitive behavioral therapy, is significantly limited. The Internet may be a key conduit for delivering this intervention. OBJECTIVE: To evaluate the efficacy of a structured behavioral Internet intervention for adults with insomnia. DESIGN, SETTING, AND PARTICIPANTS: Forty-five adults were randomly assigned to an Internet intervention (n = 22) or wait-list control group (n = 23). Forty-four eligible participants (mean [SD] age, 44.86 [11.03] years; 34 women) who had a history of sleep difficulties longer than 10 years on average (mean [SD], 10.59 [8.89] years) were included in the analyses. INTERVENTION: The Internet intervention is based on well-established face-to-face cognitive behavioral therapy incorporating the primary components of sleep restriction, stimulus control, sleep hygiene, cognitive restructuring, and relapse prevention. MAIN OUTCOME MEASURES: The Insomnia Severity Index and daily sleep diary data were used to determine changes in insomnia severity and the main sleep variables, including wake after sleep onset and sleep efficiency. RESULTS: Intention-to-treat analyses showed that scores on the Insomnia Severity Index significantly improved from 15.73 (95% confidence interval [CI], 14.07 to 17.39) to 6.59 (95% CI, 4.73 to 8.45) for the Internet group but did not change for the control group (16.27 [95% CI, 14.61 to 17.94] to 15.50 [95% CI, 13.64 to 17.36]) (F(1,42) = 29.64; P < .001). The Internet group maintained their gains at the 6-month follow-up. Internet participants also achieved significant decreases in wake after sleep onset (55% [95% CI, 34% to 76%]) and increases in sleep efficiency (16% [95% CI, 9% to 22%]) compared with the nonsignificant control group changes of wake after sleep onset (8% [95% CI, -17% to 33%) and sleep efficiency (3%; 95% CI, -4% to 9%). CONCLUSIONS: Participants who received the Internet intervention for insomnia significantly improved their sleep, whereas the control group did not have a significant change. The Internet appears to have considerable potential in delivering a structured behavioral program for insomnia. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00328250.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“However, within this growing number of studies, the range of outcomes can vary from virtually no effect to effect sizes that are similar to face-to-face interventions.”
From Behavioral Intervention Technologies: Evidence review and recommendations for future research in mental health (2013) · cites this paper as [18]
In the citing paper
“Attrition and non-adherence can also range widely, from extremely high (>95% for standalone depression sites), modest (many anxiety sites), to minimal (insomnia), depending on the disorder and how participants were sampled or screened.”
From Behavioral Intervention Technologies: Evidence review and recommendations for future research in mental health (2013) · cites this paper as [18]
In the citing paper
“Standalone interventions have produced a wide range of outcomes, from small or nonsignificant (e.g. many depression sites, substance abuse) to moderate (some anxiety disorders) to fairly large (insomnia) (14, 15, 18, 25).”
From Behavioral Intervention Technologies: Evidence review and recommendations for future research in mental health (2013) · cites this paper as [18]
In the citing paper
“The efficacy of web-based intervention has been demonstrated by a large number of trials for a number of mental health problems, including depression, anxiety disorders, alcohol and substance abuse, and insomnia (14–18).”
From Behavioral Intervention Technologies: Evidence review and recommendations for future research in mental health (2013) · cites this paper as [18]
In the citing paper
“Although initial results are promising, further work is needed because many of the trials have been relatively small [44-47].”
From Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress (2012) · cites this paper as [45]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
1 retracted
Interactive Health Communication Applications for people with chronic disease
Murray, E., Burns, J., Tai, S. S., Lai, R., & Nazareth, I. (2004) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004274.pub2 · Cited by 56
RetractedDiagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
Diagnostic and Statistical Manual of Mental Disorders.
Widiger, T. A. (2000) · Oxford University Press eBooks · doi:10.1037/10518-009 · Cited by 19,766
Spitzer, R. L. (1999) · JAMA · doi:10.1001/jama.282.18.1737 · Cited by 9,802
Validation of the Insomnia Severity Index as an outcome measure for insomnia research
Bastien, C. (2001) · Sleep Medicine · doi:10.1016/s1389-9457(00)00065-4 · Cited by 8,067 · cited 3×
“The ISI has been shown to be a valid and reliable measure that is sensitive to changes in treatment studies.(27) It was administered at preassessment and postassessment for all participants as well as at the 6-month follow-up and before each of the program cores for participants who received SHUTi.”
BackgroundMethodEpidemiology of insomnia: what we know and what we still need to learn
Ohayon, M. M. (2002) · Sleep Medicine Reviews · doi:10.1053/smrv.2002.0186 · Cited by 3,743
Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention?
Ford, D. E. (1989) · JAMA · doi:10.1001/jama.262.11.1479 · Cited by 2,440
(1993) · Medical Entomology and Zoology · Cited by 2,324
Self-citationPsychological and behavioral treatment of insomnia: update of the recent evidence (1998-2004)
Morin, C. M., Bootzin, R. R., Buysse, D. J., Edinger, J. D., Espie, C. A., & Lichstein, K. L. (2006) · Sleep · doi:10.1093/sleep/29.11.1398 · Cited by 1,345
Self-citationRecommendations for a standard research assessment of insomnia
Buysse, D. J., Ancoli-Israel, S., Edinger, J. D., Lichstein, K. L., & Morin, C. M. (2006) · Sleep · doi:10.1093/sleep/29.9.1155 · Cited by 1,206
Self-citationBehavioral and Pharmacological Therapies for Late-Life Insomnia: A Randomized Controlled Trial
Morin, C. M., Colecchi, C., Stone, J., Sood, R., & Brink, D. (1999) · JAMA · doi:10.1001/jama.281.11.991 · Cited by 1,095 · cited 1×
“”(15) In addition, individuals receiving CBT rate this intervention as more effective and acceptable than medication.(16,17) Unfortunately, availability of CBT is severely limited for many reasons, including lack of trained clinicians, poor geographical distribution of knowledgeable professionals, expense, and inacces…”
BackgroundSelf-citationInsomnia and Its Treatment: Prevalence and Correlates
Mellinger, G. D. (1985) · Archives of General Psychiatry · doi:10.1001/archpsyc.1985.01790260019002 · Cited by 1,071 · cited 1×
“Despite its prevalence and cost, only a small percentage of individuals with insomnia actually receive any type of treatment.(2,10) Cognitive behavioral therapy (CBT) for insomnia,(11,12) a psychological treatment that targets the maladaptive behaviors and dysfunctional thoughts that perpetuate sleep problems, is one…”
BackgroundWantland, D. J., Portillo, C. J., Holzemer, W. L., Slaughter, R., & McGhee, E. M. (2004) · Journal of Medical Internet Research · doi:10.2196/jmir.6.4.e40 · Cited by 966
Treatment of Chronic Insomnia by Restriction of Time in Bed
(1987) · Sleep · doi:10.1093/sleep/10.1.45 · Cited by 948
Using Internet technology to deliver a behavioral weight loss program
Tate, D. F. (2001) · JAMA · doi:10.1001/jama.285.9.1172 · Cited by 925 · cited 1×
“Future studies should include placebo control groups who are provided with some type of intervention (such as patient education Web sites).(22) In summary, these findings provide support for using the Internet as an efficacious method for delivering CBT for insomnia.”
ResultNonpharmacologic Treatment of Chronic Insomnia
Morin, C. M., Hauri, P. J., Espie, C. A., Spielman, A. J., Buysse, D. J., & Bootzin, R. R. (1999) · Sleep · doi:10.1093/sleep/22.8.1134 · Cited by 888
Self-citationInteractive Health Communication Applications for people with chronic disease
Murray, E., Burns, J., See Tai, S., Lai, R., & Nazareth, I. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004274.pub4 · Cited by 722
Prevalence, burden, and treatment of insomnia in primary care
(1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.10.1417 · Cited by 694
Tate, D. F., Jackvony, E. H., & Wing, R. R. (2003) · JAMA · doi:10.1001/jama.289.14.1833 · Cited by 666
Edinger, J. D., Wohlgemuth, W. K., Radtke, R. A., Marsh, G. R., & Quillian, R. E. (2001) · JAMA · doi:10.1001/jama.285.14.1856 · Cited by 625
Sivertsen, B., Omvik, S., Pallesen, S., Bjorvatn, B., Havik, O. E., Kvale, G., Nielsen, G. H., & Nordhus, I. H. (2006) · JAMA · doi:10.1001/jama.295.24.2851 · Cited by 589
The Subjective Meaning of Sleep Quality: A Comparison of Individuals with and without Insomnia
Harvey, A. G., Stinson, K., Whitaker, K. L., Moskovitz, D. J., & Virk, H. S. (2008) · SLEEP · doi:10.1093/sleep/31.3.383 · Cited by 459
Insomnia: A Clinical Guide to Assessment and Treatment
Morin, C. M., & Espie, C. A. (2007) · Digital Access to Libraries (Université catholique de Louvain (UCL), l'Université de Namur (UNamur) and the Université Saint-Louis (USL-B)) · doi:10.1007/b105845 · Cited by 406
Self-citationThe Direct and Indirect Costs of Untreated Insomnia in Adults in the United States
Ozminkowski, R. J., Wang, S. S., & Walsh, J. K. (2007) · SLEEP · doi:10.1093/sleep/30.3.263 · Cited by 403 · cited 1×
“The considerable costs of insomnia include psychological ramifications (decreased quality of life and impaired daytime functioning),(4,5) personal and public health consequences (impaired cognitive functioning and increased health services utilization),(4,6,7) and a staggering economic impact (estimated $41 billion in…”
BackgroundInsomnia: A Clinical Guide to Assessment and Treatment
Haynes, P. L. (2004) · SLEEP · doi:10.1093/sleep/27.2.343 · Cited by 381
SF-36: evaluation of quality of life in severe and mild insomniacs compared with good sleepers
Léger, D., Scheuermaier, K., Philip, P., Paillard, M., & Guilleminault, C. (2001) · Psychosomatic Medicine · doi:10.1097/00006842-200101000-00006 · Cited by 377
Internet interventions: In review, in use, and into the future.
Ritterband, L. M., Gonder-Frederick, L. A., Cox, D. J., Clifton, A. D., West, R. W., & Borowitz, S. M. (2003) · Professional Psychology: Research and Practice · doi:10.1037/0735-7028.34.5.527 · Cited by 352 · cited 2×
“They are usually highly structured; selfguided or semi–self-guided; based on effective face-toface treatment; personalized to the user; interactive; enhanced by graphics, animations, audio, and possibly video; and tailored to provide follow-up and feedback.(24) This study investigates the feasibility and efficacy of u…”
BackgroundMethodSelf-citationCognitive-behavioral therapy for primary insomnia
Edinger, J. D., & Means, M. K. (2005) · Clinical Psychology Review · doi:10.1016/j.cpr.2005.04.003 · Cited by 344 · cited 1×
“Unfortunately, availability of CBT is severely limited for many reasons, including lack of trained clinicians, poor geographical distribution of knowledgeable professionals, expense, and inaccessibility to treatment and clinicians.(18) One way to overcome these barriers is to use the Internet to deliver treatment, pot…”
BackgroundStoller, M. K. (1995) · PubMed · Cited by 322
Internet-Based Treatment for Insomnia: A Controlled Evaluation.
Ström, L., Pettersson, R., & Andersson, G. (2004) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.72.1.113 · Cited by 311
Bootzin, R. R., Epstein, D. R., & Wood, J. M. (1991) · Springer eBooks · doi:10.1007/978-1-4757-9586-8_2 · Cited by 307
Introduction to the special section on stepped care models in psychotherapy.
Haaga, D. A. F. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.4.547 · Cited by 259
Internet Health ResourcesPreprint
Fox, S., & Fallows, D. (2003) · SSRN Electronic Journal · Cited by 254
Luby, J. L., Si, X., Belden, A. C., Tandon, M., & Spitznagel, E. (2009) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2009.97 · Cited by 245
Bastien, C. H., Morin, C. M., Ouellet, M.-C., Blais, F. C., & Bouchard, S. (2004) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.72.4.653 · Cited by 243
Self-help treatment for insomnia: bibliotherapy with and without professional guidance.
Mimeault, V., & Morin, C. (1999) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.67.4.511 · Cited by 220
Self-citationDoes Cognitive-Behavioral Insomnia Therapy Alter Dysfunctional Beliefs About Sleep?
Edinger, J. D., Wohlgemuth, W. K., Radtke, R. A., Marsh, G. R., & Wolever, R. Q. (2001) · SLEEP · doi:10.1093/sleep/24.5.591 · Cited by 214
Patients' acceptance of psychological and pharmacological therapies for insomnia
Morin, C. M., Gaulier, B., Barry, T., & Kowatch, R. A. (1992) · SLEEP · doi:10.1093/sleep/15.4.302 · Cited by 211 · cited 1×
“”(15) In addition, individuals receiving CBT rate this intervention as more effective and acceptable than medication.(16,17) Unfortunately, availability of CBT is severely limited for many reasons, including lack of trained clinicians, poor geographical distribution of knowledgeable professionals, expense, and inacces…”
BackgroundSelf-citation(2009) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/foc.7.4.foc538 · Cited by 211
Griffiths, K. M., & Christensen, H. (2006) · Clinical Psychologist · doi:10.1080/13284200500378696 · Cited by 210
Self-help treatment for insomnia: Bibliotherapy with and without professional guidance.
Mimeault, V., & Morin, C. M. (1999) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.67.4.511 · Cited by 205
Self-citationHands-on Help: computer-aided Psychotherapy
Marks, I. M., Cavanagh, K., & Gega, L. (2007) · doi:10.25405/ncl.34083078 · Cited by 182
Symptom Reports in Severe Chronic Insomnia
Moul, D. E., Nofzinger, E. A., Pilkonis, P. A., Houck, P. R., Miewald, J. M., & Buysse, D. J. (2002) · SLEEP · doi:10.1093/sleep/25.5.548 · Cited by 181
Murray, E. J., Burns, J., Tai, S. S., Lai, R., & Nazareth, I. (2005) · UCL Discovery (University College London) · Cited by 171
The relationship between chronically disrupted sleep and healthcare use
(2002) · Sleep · doi:10.1093/sleep/25.3.289 · Cited by 169
datasets, partners, & healthinsite (2015) · Cited by 138
Self-Help Treatment for Insomnia: a Randomized Controlled Trial
Morin, C. M., Beaulieu‐Bonneau, S., LeBlanc, M., & Savard, J. (2005) · SLEEP · doi:10.1093/sleep/28.10.1319 · Cited by 109
Self-citationHypnotic taper with or without self-help treatment of insomnia: A randomized clinical trial.
Belleville, G., Guay, C., Guay, B., & Morin, C. M. (2007) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.75.2.325 · Cited by 77
Self-citationBehavioral and Pharmacological Therapies for Late-Life Insomnia: A Randomized Controlled Trial
Waweru, M., & Chandrasekhara, S. (2022) · Springer eBooks · doi:10.1007/978-3-030-94960-0_65 · Cited by 65
Effects of self-control procedures for insomnia
Bootzin, R. R. (1979) · Cited by 58
Luby, J. L., Sullivan, J. P., Belden, A. C., Stalets, M. M., Blankenship, S., & Spitznagel, E. L. (2006) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000188894.54713.ee · Cited by 52
Relief from insomnia : getting the sleep of your dreams
Morin, C. M. (1996) · Doubleday eBooks · Cited by 17
Self-citationInternet-based treatment for insomnia: a controlled evaluation
McGraw, C. (2004) · Primary Health Care · doi:10.7748/phc.14.7.8.s11 · Cited by 8
Taking telehealth to the next step
Rabasca, L. (2000) · PsycEXTRA Dataset · doi:10.1037/e378852004-017 · Cited by 8
Research works printed but not linked: 1
- [30]Bootzin RR Stimulus control treatment for insomnia Proceedings of the American Psychological Association 1972 7 395 396
Cited by
Sorted by citations
European guideline for the diagnosis and treatment of insomnia
Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Dolenc Groselj, L., Ellis, J. G., Espie, C. A., Garcia‐Borreguero, D., Gjerstad, M., Gonçalves, M., et al. (2017) · Journal of Sleep Research · doi:10.1111/jsr.12594 · Cited by 2,049
“These six meta-analyses focus on self-help CBT-I approaches (Ho et al., 2015; Van Straten and Cuijpers, 2009), or internet-based CBT-I, for example, the programmes ‘sleep healthy using the internet’ (SHUTi; Ritterband et al., 2009) or SLEEPIO (Espie et al., 2012).”
Qaseem, A., Kansagara, D., Forciea, M. A., Cooke, M., Denberg, T. D., & for the Clinical Guidelines Committee of the American College of Physicians* (2016) · Annals of Internal Medicine · doi:10.7326/m15-2175 · Cited by 1,965
“Improvements were seen across the various methods of CBT-I delivery, including in-person individual therapy (18, 24, 33, 35, 36), in-person group therapy (19, 20, 31), telephone-based modules (21), Web-based modules (17, 22, 23, 25), and self-help books (26, 29, 37); however, evidence was insufficient to determine the…”
MethodMorin, C. M., & Benca, R. (2012) · The Lancet · doi:10.1016/s0140-6736(11)60750-2 · Cited by 976
Self-citationDefining Internet-Supported Therapeutic Interventions
Barak, A., Klein, B., & Proudfoot, J. G. (2009) · Annals of Behavioral Medicine · doi:10.1007/s12160-009-9130-7 · Cited by 731
“net; [17]), a CBT web-based program for insomnia, provides text, pictorial, animation, and audio formats.”
BackgroundMohr, D. C., Burns, M. N., Schueller, S. M., Clarke, G., & Klinkman, M. (2013) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2013.03.008 · Cited by 693
“including depression, anxiety disorders, alcohol and substance abuse and insomnia [14–18].”
Metadata
- Authors
- Ritterband, L. M., Thorndike, F. P., Gonder-Frederick, L. A., Magee, J. C., Bailey, E. T., Saylor, D. K., & Morin, C. M.
- Affiliations
- University of Virginia Health System (US)
- ORCID
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2009-07-01
- Volume
- 66
- Issue
- 7
- Pages
- 692
- ISSN
- 0003-990X (ISSN-L)
- PMC
- PMC3723339
- OpenAlex
- W2126133436
- Cited by
- 482
- References
- 52
- Citations by year
- 2026: 19 · 2025: 18 · 2024: 25 · 2023: 28 · 2022: 28 · 2021: 26 · 2020: 23 · 2019: 24 · 2018: 31 · 2017: 31 · 2016: 30 · 2015: 44 · 2014: 28 · 2013: 33 · 2012: 33
- FWCI
- 39.71
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R34 MH70805, R34MH070805)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Keywords
- insomnia, online intervention, cognitive behavioral therapy, sleep restriction, stimulus control, sleep hygiene, cognitive restructuring, relapse prevention, insomnia severity, wake after sleep onset, sleep efficiency, treatment efficacy, maintenance of treatment gains, waitlist control, follow-up outcomes, Insomnia Severity Index, sleep diary, cost-effectiveness, acceptability
- MeSH terms
- Adult, Feasibility Studies, Female, Follow-Up Studies, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Patient Education as Topic, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Treatment Outcome, Self Efficacy, Internet
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
