Computerized Cognitive Behavioral Treatment for Insomnia: Improving Rural Veteran Access to Evidence-Based Treatment to Reduce Suicide Risk



Status:Enrolling by invitation
Conditions:Insomnia Sleep Studies, Psychiatric
Therapuetic Areas:Psychiatry / Psychology
Healthy:No
Age Range:18 - 89
Updated:1/6/2019
Start Date:April 28, 2018
End Date:December 2019

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Insomnia is a major problem among veteran populations. Insomnia impacts physical and mental
health functioning and is associated with reduced quality of life. Cognitive Behavioral
Therapy for Insomnia (CBT-I) is one of the most promising treatments for insomnia; however,
access to CBT-I is severely limited by a lack of trained clinicians within the Veterans
Health Administration (VHA). There is a critical need to offer innovative approaches to meet
the demand and need for insomnia treatment. Leveraging technology to meet treatment demands
is consistent with service delivery models based upon stepped care principles. This
randomized controlled trial will determine whether a computerized, self-guided, web-based
version of CBT-I is efficacious in reducing insomnia symptoms and improving functioning
compared to a computerized program control.


Inclusion Criteria:

1. Age between 18 and 89

2. Eligible to receive care through VA ECHCS

3. Reliable access to the Internet

4. English speaking

5. Able to provide informed consent

6. Current insomnia diagnosis as defined by Diagnostic and Statistical Manual of Mental
Disorders 5 (DSM 5) criteria38

Exclusion Criteria:

1. Currently enrolled in/participating in other intervention research studies

2. Other untreated sleep disorders (e.g., sleep apnea, periodic limb movement)

3. Currently receiving formal psychological treatment for insomnia (not including sleep
medications)

4. Past 3 month change in schedule and/or dosage of medications that are designed to
improve/impact sleep

5. History of Bipolar Disorder (with manic episodes), Schizophrenia, Schizoaffective
Disorder, or a Psychotic Disorder

6. Untreated seizures or seizure disorder

7. Physical illness that is active, unstable, degenerative, and/or progressive

8. Currently pregnant or plan to become pregnant in the next 6 months

9. Irregular work schedule, shift work, and/or life changes (e.g., new baby) interfering
with regular sleep patterns

10. Significant cognitive impairment, as determined by chart review and/or during
screening, that would interfere with ability to engage in SHUTi

11. Current non-alcohol Substance Use Disorder, excluding Cannabis Use Disorder, as
determined by chart review and/or self-report screen of drug use (> 1 time) in past 3
months

12. Current alcohol use diagnosis, as determined by SCID 5 module, in the past 3 months
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