For face-to-face therapy, two to four sessions are typically scheduled every few weeks, though six to eight sessions are also common, Schneeberg says. Online programs take about the same amount of time; the programs now in use by insurers offer five to six sessions that users typically access once a week, though they can go through the program faster if they wish. Both online and face-to-face programs begin with a health assessment. Although insomnia often has no underlying physical cause, it can be a side effect of a medical condition such as Parkinson's disease, depression or cancer. In a 2006 article published in the journal Sleep, Charles M. Morin, a sleep researcher from Universite Laval in Quebec, reviewed 37 studies on cognitive behavior therapy for insomnia and ultimately suggested that it be the first-line treatment -- over medication.
Counting sheep but no sleep?
Cognitive behavior therapy -- offered online by insurers -- is more effective than pills, an expert says.
MEDICINE
For The Record
Los Angeles Times Friday, December 19, 2008 Home Edition Main News Part A Page 2 National Desk 1 inches; 53 words Type of Material: Correction
Insomnia treatment: An article in the Nov. 3 Health section about online therapy for insomnia was incorrect in saying that a blog for the annual meeting of the American Academy of Sleep Medicine did not refer to the therapy. The blog did in fact refer to a study about online therapy for insomnia.
For The Record
Los Angeles Times Monday, December 22, 2008 Home Edition Health Part F Page 5 Features Desk 1 inches; 53 words Type of Material: Correction
Insomnia treatment: An article in the Nov. 3 Health section about online therapy for insomnia was incorrect in saying that a blog for the annual meeting of the American Academy of Sleep Medicine did not refer to the therapy. The blog did in fact refer to a study about online therapy for insomnia.
Further, Morin said in the article that the studies showed the therapy is effective for older patients and for people whose other health issues, such as chronic illness, may be contributing to their sleeplessness. Those two groups are notoriously hard to treat for sleep problems.
The lack of trained professionals has prevented the academy from pushing the therapy to the front of the list of treatments, Sateia says.
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Web sessions
The online programs simulate many of the strategies used in face-to-face counseling. Overcoming Insomnia, for example, the program now in use by Highmark, Aetna and Kaiser Permanente, teaches users to evaluate their thoughts and beliefs and reminds them that "not all of our thoughts and beliefs are based on facts."
Users can repeat sessions as often as they like, which helps reinforce a positive attitude toward getting to sleep -- much as they'd be reminded to try to dispel negative notions in a face-to-face setting, says Richard Bedrosian, head of mental health at HealthMedia of Ann Arbor, Mich., which sells Overcoming Insomnia. The programs also teach relaxation techniques -- such as concentrating on breathing while turning attention away from worry about sleep.
Consumers don't have to go through their insurer to try the programs. Conquer Insomnia, an early version of the program now used by Kaiser, Aetna and Highmark, is available for $19.95 at www.myselfhelp.com. Conquering Insomnia, a version of the program being used by Blue Cross Blue Shield of Massachusetts, is available for $24.95 at CBTforinsomnia.com.
