Sleep problems are structurally underestimated. This is concerning, because lack of sleep can lead to serious consequences. According to Professor of Clinical Psychology at VU Annemieke van Straten, sleep problems can be treated well through cognitive behavioural therapy (CBT).
In collaboration with various experts, she therefore developed the online CBT module i-Sleep. The module has proven effective in reducing sleep complaints and is currently being examined as to whether it will be useful and effective when used in GP practices.
'People often don’t seek help, because they think that nothing can be done'
There are various recent studies surrounding insomnia and its effects, including one led by geneticist Richa Saxena of Massachusetts General Hospital in Boston that showed an apparent link between insomnia and other illnesses including depression and heart disease.
Sleep deprival can lead to depression
According to Annemieke van Straten, it is often initially the people with sleep problems themselves who underestimate the problem. "Often, they do not seek help either, because they think there is nothing to be done about it." This is particularly bad when you consider the serious consequences that sleeping problems can lead to in the long term, such as a reduced quality of life, depression or physical illnesses.
In addition, it isn't beneficial to society if a large number of people suffer from sleeping problems. "People work less efficiently and take days off work", explains van Straten. "That costs society money."
Using cognitive therapy rather than medication
People with sleeping disorders who do visit their GP are usually prescribed sleeping medication. "But GPs should really be careful about prescribing those," Van Straten says. "Medication is effective in the short term, but can have unpleasant side effects. It often leads to drowsiness and it is addictive, so people need an increasingly higher dose."
According to Van Straten, it is much better to prescribe cognitive behavioural therapy (CBT). “Therapy does not have all of these side effects and also works better in the long term. A referral to a psychologist is therefore the best solution. But, the situation in the Netherlands has changed. There is no reimbursement anymore for treatment at a mental health institution if you have a sleeping disorder.
GP’s fill the gaps now; the supportive mental health staff at practices could pick this up. However, these staff members come from different backgrounds and can vary from psychiatrists to psychological wellbeing practitioners (PWPs). So we can’t expect the GP’s and their mental health staff to know all about CBT in case of sleeping problems.”
i-Sleep: online therapy for sleep problems
An online module to offer this therapy can therefore be a solution, allowing patients to follow the therapy themselves. Moreover, a module like this provides all mental health staff with a good guide for treating sleep problems. Van Straten developed i-Sleep herself, in collaboration with other experts, a couple of years ago.
i-Sleep is an online cognitive behavioural therapy that is offered through the Minddistrict ehealth platform and where patients receive online support. The course includes psychoeducation, sleep hygiene, stimulus control, sleep restriction, and cognitive therapy aimed at countering non-helpful thoughts. All of them are elements that are essential in CBT for sleep problems.
'It would be fantastic if more people were offered online therapy and less would receive medication'.
Positive results in the i-Sleep research
Van Straten has now shown that the course is effective. "People who follow the module report fewer sleep problems. In addition, they reported less gloom, less fear and a better quality of life. People were satisfied with the course and almost 75% of those who started the course went on to finish it."
This study was conducted among people who were recruited in the general population and were guided by coaches working at the university. A large study is currently underway to determine whether i-Sleep is also useful and effective in regular care. Patients who turn to their GP for help are referred to the course where the mental health staff offer support. "It would be fantastic if more people were offered online therapy and less medication."
Scientific publications about sleep problems
Do you want to know more? View further articles from Annemieke van Straten.
- 'Does online insomnia treatment reduce depressive symptoms? A randomized controlled trial in individuals with both insomnia and depressive symptoms' in Psychological Medicine (van der Zweerde, T., van Straten, A., Effting, M., Kyle, S. D., Lance, J.).
- 'Guided Internet-delivered cognitive behavioural treatment for insomnia: a randomized trial' in Psychological Medicine (A. van Straten, J. Emmelkamp, J. de Wit, J. Lancee, G. Andersson, E. J. W. van Someren and P. Cuijpers).
Would you like to know more about the module i-Sleep and the possibilities of the Minddistrict ehealth platform?
The Minddistrict catalogue of interventions also includes self-help training courses, diaries and other tools to help people sleep better. View them under the theme ‘Getting a good night's rest’.