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Wednesday 23rd May 2018

Online therapy for insomnia

3rd November 2008

Several top-tier health insurance companies in the United States now see treating insomnia as a top priority.


Several insurers, including WellPoint, Aetna, Cigna, Kaiser Permanente and several Blue Cross plans, are now are advocating the use of cognitive behavior therapy via websites.

This kind of therapy is usually offered face-to-face, but the online programmes aim to cure insomnia, not just relieve its symptoms.

According to Meir H Kryger, director of sleep medicine at Gaylord Hospital in Wallingford, Connecticut, the treatment works better than sleeping pills, and frees sufferers from their side-effects, too.

The companies want to reduce the tens of millions spent on sleeping pills each year, and have an impact on medical conditions that may be caused by a lack of sleep, experts say.

Figures published by the National Institutes of Health show that as many as 70 million Americans have trouble either falling asleep, staying asleep, or wake up too soon.

And about 20 million people have trouble staying awake or maintaining concentration during daylight hours as a result.

Insomnia can contribute to conditions like high blood pressure, depression, accidents, and lower productivity at work.

Michael Twery, director of the National Center on Sleep Disorders Research, a division of the NIH, said sleep could be as important as diet and exercise in maintaining good health.

A good night's sleep boosts the chances of optimal cardiovascular and metabolic health, while outlook, mood, performance, vigilance and response to the world around us can all be impaired by lack of sleep.

In 2006, 8,194 people per 100,000 were taking some form of sleeping medication, according to a study published earlier this year in the journal Health Affairs.

That compares with just 5,445 people per 100,000 in 1998.

While some sleeping tablets are available in cheaper, generic forms, newer drugs like Lunesta and Rozerem can cost as much as US$1,500 per annum per person.

But the online behavioural therapy programmes cost less than $40 per user. And even face-to-face counselling will only cost the insurer from between US$300 and US$1,800, depending on individual circumstances.

Part of the American Academy of Sleep Medicine's clinical guidelines for treating insomnia, cognitive behavioural therapists work with people to eliminate sleep-related fears and misconceptions, which often in themselves prevent people from sleeping.

Approaches might include the use of sleep-restriction exercises to encourage drowsiness, or stimulus control, for example, not using the bedroom for any purposes other than sleeping or sex.

Cutting out alcohol and exercise in the hours before bed are also common strategies.

The programmes, whether offered online or face-to-face, typically begin with a health assessment, as insomnia can be a side-effect of medical conditions like Parkinson's disease, depression or cancer.

Sleep researchers have recommended cognitive behavioural therapy as a first-line treatment for insomnia, over medication.


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