A randomized controlled trial comparing guided internet-based multi-component treatment and internet-based guided sleep restriction treatment to care as usual in insomnia.

Krieger, Tobias; Urech, Antoine; Duss, Simone B.; Blättler, Larissa; Schmitt, Wolfgang; Gast, Heidemarie; Bassetti, Claudio; Berger, Thomas (2019). A randomized controlled trial comparing guided internet-based multi-component treatment and internet-based guided sleep restriction treatment to care as usual in insomnia. Sleep medicine, 62, pp. 43-52. Elsevier 10.1016/j.sleep.2019.01.045

[img] Text
1-s2.0-S1389945718307792-main.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (557kB) | Request a copy

BACKGROUND Internet-based cognitive behavioral treatment (iCBT-I) for insomnia comprising different sleep-related cognitive and behavioral interventional components has shown some promise. However, it is not known which components are necessary for a good treatment outcome. METHOD People suffering from insomnia (N = 104) without any other comorbid psychiatric disorders were randomized (2:2:1) to two guided internet-based self-help interventions for insomnia [multi-component cognitive behavioral self-help intervention (MCT); sleep restriction intervention for insomnia (SRT)], and care as usual [CAU]. In all three conditions, additional care or treatment was allowed. The primary outcome was insomnia severity measured with the insomnia severity index (ISI) at eight weeks. Furthermore, the two active conditions were compared regarding sleep efficacy from daily diary data over the eight weeks, and other measures from the daily protocols. Secondary outcomes included sleep quality, depressive symptoms, dysfunctional beliefs, and quality of life at post-treatment (eight weeks) and follow-up (six months after randomization). RESULTS Both conditions were more effective than CAU at post-treatment, with medium to large between-group effect sizes on the primary outcome (ISI; MCT: Cohen's d = -1.15; SRT: d = -0.68) and small to medium between-group effect sizes for secondary outcomes. Treatment gains were maintained at six-month follow-up. Active conditions did not differ from each other on all measures from pre to post, except for dysfunctional beliefs about sleep, and sleep protocol data throughout the intervention. Participants in MCT were significantly more satisfied with the intervention than participants in SRT. CONCLUSIONS Results of the present study indicate that CAU + MCT and CAU + SRT are both effective compared to CAU. There were no statistical differences regarding efficacy between the two active conditions, but participants in MCT reported to be more satisfied with the intervention.

Item Type:

Journal Article (Original Article)


07 Faculty of Human Sciences > Institute of Psychology > Clinical Psychology and Psychotherapy
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Translational Research Center

UniBE Contributor:

Krieger, Tobias; Duss, Simone; Blättler, Larissa Tatjana; Schmitt, Wolfgang; Gast, Heidemarie; Bassetti, Claudio and Berger, Thomas


600 Technology > 610 Medicine & health








Melanie Best

Date Deposited:

08 Oct 2019 09:55

Last Modified:

30 Mar 2020 14:34

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Cognitive behavioral treatment Insomnia Internet-based intervention Online intervention Sleep restriction





Actions (login required)

Edit item Edit item
Provide Feedback